1272 Are We Repeating MRI Prostate Scans Unnecessarily in Our Management of Suspected or Confirmed Prostate Cancer Patients, When Referred to Urology

Aim

MRI Prostate aids in the detection of prostate cancer, however often following a single MRI if cancer is suspected or confirmed, subsequent MRIs are performed, and it is unclear if these are unnecessarily repeated.

Method

We reviewed 196 patients who underwent at least two MRI prostate scans between January 2019 to December 2022. Imaging, clinic letters and MDT reports were reviewed with active surveillance (AS), treatment initiated or discharge back to GP as management outcomes. We analysed whether management changed following multiple MRIs.

Results

Following a single MRI scan 115/196 (59%) commenced/continued AS and 81/196 (41%) were discharged. Following a second MRI 83/115 (72%) continued AS, 18/115 (16%) commenced treatment and 14/115 (12%) were discharged. 69/115 (60%) AS patients had a repeat MRI within one year with the majority (46/69, 67%) continuing AS, 11/69 (16%) being discharged and 12/69 (17%) commencing treatment.

In those 81/196 initially discharged, 56/81 (69%), were discharged following repeat MRI, 18/81 (22%) started AS and 7/81 (9%) commenced treatment. 19/81 (23%) patients underwent repeat MRI within one year with 13/19 (68%) subsequently discharged, 4/19 (21%) starting AS and 2/19 (11%) commencing treatment.

Conclusions

MRI is an important tool for diagnosis and AS in those with (suspected) prostate cancer, however we have shown that in the majority of patients, repeat MRI does not change the outcome of requiring treatment or AS in those initially discharged subsequent to MRI, particularly within 1 year. Discharged patients may require repeat imaging, however repeating this at a longer interval should be strongly considered.