Diagnostic accuracy of a ‘stage-gated’ approach for reporting prostate screening MRI: “Is less more?”

Question The PPV of MRI in PCa screening is low, likely because conventional assessment systems are not optimised for low disease prevalence populations. Findings A two-step, 'stage-gated' reading approach achieved a PPV of 53% (8/15), compared to 29% (8/28) for Likert and 30% (11/37) for PI-RADS scores ≥ 4. Clinical relevance The 'stage-gated' reporting approach, which uses limited sequences for the initial read, may improve the PPV and benefit-to-harm ratio of MRI-based screening by reducing unnecessary biopsies. Prospective evaluation is needed to confirm these findings in real-world screening settings.

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Publication Details

Journal
European Radiology
Published
2026-02-19
DOI
https://doi.org/10.1007/s00330-025-12250-4
Citations
1
Primary Topic
Prostate Cancer Diagnosis and Treatment
Type
article
Field-Weighted Citation Impact
36.44

Funders

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article

Diagnostic accuracy of a ‘stage-gated’ approach for reporting prostate screening MRI: “Is less more?”

Tristan Barrett, D Atkinson, Haroon Ahmed, Penny L. Hubbard Cristinacce et al.
1 citations
European Radiology
Prostate Cancer Diagnosis and Treatment
36.44
article

Diagnostic accuracy of a ‘stage-gated’ approach for reporting prostate screening MRI: “Is less more?”

Tristan Barrett, D Atkinson, Haroon Ahmed, Penny L. Hubbard Cristinacce, Fiona Gong, Heminder Sokhi, Henry Tam, Alistair Lamb, Giorgio Brembilla, Tom Parry, Francesco Giganti, Natasha Thorley, Anwar R. Padhani, David Eldred-Evans, Nikhil Mayor, Caroline M. Moore, Shonit Punwani
article en
1 citations

Abstract

Question The PPV of MRI in PCa screening is low, likely because conventional assessment systems are not optimised for low disease prevalence populations. Findings A two-step, 'stage-gated' reading approach achieved a PPV of 53% (8/15), compared to 29% (8/28) for Likert and 30% (11/37) for PI-RADS scores ≥ 4. Clinical relevance The 'stage-gated' reporting approach, which uses limited sequences for the initial read, may improve the PPV and benefit-to-harm ratio of MRI-based screening by reducing unnecessary biopsies. Prospective evaluation is needed to confirm these findings in real-world screening settings.

European Radiology
University College London Hospitals NHS Foundation Trust (GB), Imperial College Healthcare NHS Trust (GB), Vita-Salute San Raffaele University (IT), University of Cambridge (GB), Hillingdon Hospitals NHS Foundation Trust (GB), Mount Vernon Hospital (GB), Istituti di Ricovero e Cura a Carattere Scientifico (IT), Addenbrooke's Hospital (GB), Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele (IT), University College London (GB), Imperial College London (GB)
Wellcome Trust, National Institute for Health and Care Research, Royal College of Surgeons of England, Imperial College London, Fondation pour la Recherche Médicale, Urology Foundation, BMA Foundation for Medical Research, NIHR Imperial Biomedical Research Centre
Peace, Justice and strong institutions
Openalex Percentile: Top 1%
Prostate Cancer Diagnosis and Treatment
36.44
DOIOpen Access PDFOpenAlex
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