Preoperative MRI Improves Surgical Outcomes for Prostate Cancer Patients

Systematic prostate biopsies are often used to locate cancerous tissue and guide treatment. While magnetic resonance imaging (MRI) can yield greater insight into tumor characteristics, the extent to which it improves treatment outcomes has not been explored on a wide scale. Now, a study examining the association between preoperative MRI usage and surgical outcomes in prostatectomy patients has demonstrated that MRI may significantly reduce postoperative complications.

In the study, researchers at the Brigham and Women’s Hospital (Boston, MA, USA) examined the association between preoperative MRI usage and surgical outcomes in 19,369 prostatectomy patients from 2004-2015. In analyzing Medicare claims linked to the Surveillance, Epidemiology, and End Results (SEER) database, a cancer registry representative of the US population, the researchers found significant postoperative benefits for patients who received MRI. They identified a reduced likelihood that cancerous cells may remain in the patient after the operation (a “positive surgical margin”) and reduced odds of blood transfusions at 30 and 90 days after the operation. Notably, the researchers found that preoperative MRI was associated with higher likelihood of further treatment, but they hypothesize that MRI may be associated with more resource-intensive cancer care overall.

While the proportion of prostatectomy patients receiving preoperative MRI increased over the study period nearly tenfold, from 2.9% to 28.2%, the use of MRI in different regional health care markets varied widely, ranging from 0% to 28.8%. Factors such as cost, health literacy and availability of imaging may affect whether a man with prostate cancer receives an MRI, according to the researchers.

“Overdiagnosis, overtreatment and toxicity associated with treatment are big problems with prostate cancer, but MRI can help reduce unnecessary biopsies and improve surgical outcomes,” said corresponding author Alexander Cole, MD, of the Brigham’s Division of Urology. “Work by our team has shown that early diagnosis and access to care really makes a difference for prostate cancer treatment.”

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Brigham and Women’s Hospital