Prostate cancer is a leading cause of cancer among men in the United States, second only to skin cancer. According to the National Cancer Institute, prostate cancer affects more than 160,000 men in the U.S. Almost 30,000 men will die from the disease in 2018.
The use of Magnetic Resonance Imaging (MRI) to detect prostate cancer has gained increasing acceptance by the medical community in the last five to seven years. Evidence suggests that a baseline MRI can catch cancers that other exams or a biopsy might miss, identify patients with aggressive forms of prostate cancer, and assist doctors in determining the severity of a patient’s cancer.
“We now have good credible data at Yale, and many other places, that show if you do the MRI before an ultrasound biopsy you can use the MRI to target the cancer. We were the first in Connecticut doing this,” said Jeffrey Weinreb, MD, professor of radiology and biomedical imaging and chief of MRI Service.
“We use MRI data to create a three-dimensional map of the prostate, and that information is fused with an ultrasound study using specialized software by our urologist colleagues,” said Weinreb, a leading authority on the use of MRI for the pelvis, and a recipient of a 2017 Gold Medal from the American College of Radiology for distinguished service.
The bottom line: Patients receive more appropriate care with fewer having surgery or radiation therapy if they don’t need it. This, in turn, could reduce the number of patients dealing with what can be serious side effects of prostate cancer treatment.
Men who are in their 40s or 50s generally should be screened for prostate cancer. People with a higher risk, such as African American men and those with a family history of the disease, should consider more aggressive screening, Weinreb said.
A new standardized reporting and data system that Weinreb has been instrumental in creating, the Prostate Imaging Reporting and Data System Version 2 (PI-RADS v2) allows specialists such as urologists, radiation oncologists, radiologists, and pathologists to “all speak the same language and work as a team to facilitate optimal care for our patients,” Weinreb said.
“Prostate cancer diagnosis and management is changing rapidly,” Weinreb said. “People will get appropriate care; If they need surgery, ablation therapy, radiation surgery or other treatments, they will get it. In some cases, MRI and MRI-ultrasound fusion targeted biopsies can provide critical information that will result in a decision to undergo no treatment at all. The end result is that we should see better outcomes and lower costs.”