Cost-effectiveness study highlights MRI's value for prostate cancer biopsy

Tuesday, November 30 | 3:00 p.m.- 4:00 p.m. | SSGU04-1 | Room E353C

In this Tuesday presentation, Dutch researchers will share findings from a study they conducted to explore the most cost-effective MRI biopsy strategy for men with suspected prostate cancer.

MRI has shown benefits over the conventional prostate biopsy strategy of systematic transrectal ultrasound, including finding more cancers, reducing overdiagnosis, and reducing unnecessary biopsies, a team led by Dr. Maarten de Rooij, PhD, wrote in the study abstract.

But how to proceed after a suspicious prostate MRI -- that is, whether to combine MRI with transrectal ultrasound or whether the ultrasound can be eliminated altogether -- has remained unclear. Therefore, De Rooij's group sought to evaluate the cost-effectiveness of MRI-directed biopsy strategies compared with using transrectal ultrasound without prior MRI.

The study consisted of a decision analytic model based on an 18-year time frame in men who had not undergone biopsy but were suspected of having prostate cancer. The group compared the following strategies:

1. Transrectal ultrasound (TRUS) guided biopsies in all men, without prior MRI
2. MR-targeted biopsies only in case of suspicious MRI
3. MR-targeted and TRUS-guided biopsy in case of suspicious MRI
4. MR-targeted and TRUS-guided biopsy in case of suspicious MRI and TRUS-guided biopsy after negative MRI

A strategy was considered cost-effective if the cost of gaining one quality-adjusted life year did not exceed $23,000.

The team found that although all the MRI strategies were more cost-effective than the conventional TRUS-guided biopsy strategy, the strategy of performing both MR-targeted and TRUS-guided biopsy after suspicious MRI was the most cost-effective.

"The outcomes of this cost-effectiveness study are helpful for policymakers and clinicians, to guide a decision about the best biopsy strategy in men suspected of prostate cancer," the team concluded.