In Australia, prostate cancer is the leading cause of male cancer, and the second leading cause of male cancer deaths. In 2016, 3,398 men died as a result of prostate cancer and the incidence is set to double by 2030 due to an ageing population.
Over the last decade, advancements have been made in the detection of prostate cancer utilising Prostate MRI and Positron Emission Tomography (PET).
Prostate MRI is now able to detect around 75% of clinically significant prostate cancers and also correctly clear men of significant disease with a negative MRI in over 90% of cases. It can be performed in either hospital or suburban clinics, utilising the latest “3T” MRI technology, without the need for a rectal probe.
Once a cancer has been identified utilising MRI, it’s exact location can be used to perform a “targeted” biopsy by your Urologist, leading to more accurate pathology results (20% higher detection rate than “blind” biopsy) and therefore a more correctly tailored treatment plan, with a minimum number of biopsies required (50% less samples required than traditional methods).
On July 1st this year, the government introduced a Medicare rebate for Urologist referred Prostate MRI, which means if you meet specific criteria, there will be no out-of-pocket expense for your visit.
Prostate-Specific Membrane Antigen (PSMA) PET is also now being utilised, to not only confirm the diagnosis of prostate cancer, but to detect the spread of disease into structures such as pelvic lymph nodes or bones.
The aim of both these imaging advancements is to firstly increase the detection of clinically significant prostate cancer and to ensure that patients are assigned to the correct treatment regimen based on accurate pathology results, with a minimum number of biopsies. Secondly, they aim to reduce the diagnosis of low-grade, clinically “insignificant” cancers, that so often previously left both patients and doctors with difficult decisions about treatment versus surveillance and has lead to significant over treatment and subsequent unnecessary morbidity.
Dr Justin Baulch
Abdominal and Pelvic Imaging, Musculoskeletal MRI and Ultrasound, Sports Imaging
Partner Radiologist- Qscan Radiology