Preoperative MRI May Benefit Some Prostate Surgery Patients

Magnetic Resonance Imaging was associated with a lower risk of positive surgical margins in men with cT1 prostate tumors, but not in other subgroups.
Magnetic Resonance Imaging was associated with a lower risk of positive surgical margins in men with cT1 prostate tumors, but not in other subgroups.

Magnetic resonance imaging (MRI) of the prostate prior to surgery for prostate cancer does not significantly decrease the likelihood of positive surgical margins (PSMs) overall, but it may be beneficial for men with cT1 tumors, a recently published Norwegian study suggests.

The study is the first randomized controlled trial to evaluate the benefit of MRI prior to robot-assisted laparoscopic prostatectomy (RALP), according to a research team led by Erik Rud, MD, of Oslo University Hospital in Oslo.

Dr. Rud and his colleagues preoperatively randomly assigned 438 men scheduled for RALP to undergo preoperative MRI (222 men) or no MRI (216 men). PSMs were identified in 19% of the MRI group and 23% of the no-MRI group, a non-significant difference. In a subgroup analysis of men with cT1 tumors—which made up 55% of the cohort—16% of the MRI group had PCMs versus 27% of the no-MRI group, a difference that translated into a 41% relative risk reduction in the MRI group, Dr. Rud's group reported online ahead of print in European Urology.

The authors acknowledged that their study cannot explain the precise mechanisms for the decrease rate of PSMs in men with cT1 tumors.

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