Specialised MRI could be an alternative to biopsies when deciding if prostate cancer patients should receive treatment or continue with surveillance, a study has found.
Scientists at The Institute of Cancer Research, London, took scans of patients with untreated prostate cancer using diffusion-weighted (DW)-MRI, which they found could predict the aggressiveness of the disease and whether or not immediate treatment was required.
The study, which was published in the journal
European Urology, was funded by the NIHR Biomedical Research Centre at The Royal Marsden and the ICR.
As prostate cancer is often slow growing, suitable patients may be closely monitored through a system of active surveillance rather than being put on treatment.
Biopsies, which are invasive and painful for patients, are often used to select those who are suitable for active surveillance and for monitoring disease progression.
As an alternative to biopsies, the researchers used DW-MRI to measure the movement of water molecules within body tissues. This helped them to determine the apparent diffusion coefficient (ADC) of the prostate tissue, which is relatively high in normal prostate tissue, but low in cancerous prostate tissue.
When the ADC score of prostate tissue was recorded in cancer patients over a period of nine and a half years, the researchers found that it was a useful indicator for predicting which cancers required treatment.
This technique could be used in the future as a replacement for biopsies to better predict early on which patients should be selected for monitoring and which require treatment.
Professor David Dearnaley, Professor of Uro-Oncology at the ICR and a consultant at The Royal Marsden, said: “This long-term study has shown strong evidence that ADC is a useful marker when selecting patients to be put on active surveillance. We are continuing to evaluate the use of routine DW-MRI to assess whether this might be a suitable alternative to using repeated biopsies throughout surveillance.”