Pre-prostate biopsy magnetic resonance imaging (MRI) use increased from 2017 to 2026, according to a study published online Sept. 17 in JAMA Oncology.
Stephen Rhodes, Ph.D., from the University Hospitals Cleveland Medical Center, and colleagues examined data on MRI adoption for detection of prostate cancer. A total of 505,206 biopsies from 474,026 patients were analyzed.
The researchers found that for biopsy-naive patients, prebiopsy MRI use increased from 13.9 percent in 2017 to 64.1 percent in January to June of 2026. Patients with prior negative biopsy results had consistently higher MRI use, increasing from 38.4 to 66.7 percent from 2017 to 2026. There was no significant variation seen in use by rural-urban commuting area category using data from 2024 onward. There was significant variation observed by race, with an increased likelihood of receipt of prebiopsy MRI for non-Hispanic White versus non-Hispanic Black patients for both biopsy-naive patients and those with prior negative biopsy results (odds ratios, 1.36 and 1.33, respectively).
“As we’ve expanded access to advanced prostate cancer diagnostics, we’ve also worked to streamline the patient journey,” senior author Jonathan Shoag, M.D., also from the University Hospitals Cleveland Medical Center, said in a statement. “By combining early detection, personalized navigation, and improved access to care, we’re helping patients move more efficiently from concern to diagnosis and, when necessary, treatment.”
Several authors disclosed ties to the biopharmaceutical and medical technology industries.
Black men have the highest prostate cancer incidence and mortality rate in the United States compared with men of other racial and ethnic groups. One in six Black men will be diagnosed with prostate cancer in their lifetime, compared to 1 in 8 men overall.
Earlier and more accurate risk stratification remains a major priority in this population. MRI-guided diagnostic pathways may help identify clinically significant cancers while reducing unnecessary biopsies.
Black patients have historically faced disparities in prostate cancer screening, diagnosis, and treatment. Additionally, access to advanced imaging varies across health systems.
Increased guideline-concordant MRI use could improve diagnostic precision, but only if access barriers are addressed. Clinicians should consider whether MRI resources are equitably available within their practice settings and referral networks.
Several factors can influence when a prostate cancer risk assessment is performed, including family history, genetic risk factors, and race. An MRI can help guide biopsy decisions, particularly when a patient’s PSA is elevated, or prior biopsy findings are unclear.
With this in mind, clinicians should discuss diagnostic options with high-risk patients and explain the benefits and limitations of MRI-informed pathways.
While the latest findings are promising, clinicians should prioritize shared decision-making throughout the screening, diagnostic, and treatment process for prostate cancer.
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