AUA updates statement on multiparametric MRI use for prostate cancer

The American Urological Association (AUA) has updated its early policy statement on the use of multiparametric MRI for diagnosis, staging and management of prostate cancer. This updated standard operating procedure (SOP) provides practical recommendations for MRI use in the screening, diagnosis, staging, treatment, and surveillance of prostate cancer.

According to the update, published in the Journal of Urology, the utility of prostate MRI in the risk stratification, diagnosis, and treatment pathway of men with prostate cancer is expanding.

"When a quality prostate MRI is obtained, current evidence now supports its use in men at risk of harbouring prostate cancer prior to their first biopsy, as well as in men with a rising PSA following an initial negative standard prostate biopsy procedure," write the authors.

Marc A. Bjurlin, University of North Carolina, Chapel Hill, North Carolina, and colleagues updated the prior AUA SOP for MRI of the prostate and summarized the available data about the technique and clinical use of MRI in the diagnosis and management of prostate cancer.

For updating the statement, a panel of clinicians from the AUA and SAR with expertise in the diagnosis and management of prostate cancer evaluated the current published literature on the use and technique MRI for this disease. When adequate studies were available for analysis, recommendations were made on the basis of data and when adequate studies were not available, recommendations were made on the basis of expert consensus.

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Updated recommendations include:

• Prostate MRI should be performed according to technical specifications, technique standards, and interpreted according to standard reporting.


• Data support the use of MRI in men with a previous negative biopsy and ongoing concerns about an increased risk of prostate cancer.


• Sufficient data now also exist to support the recommendation of MRI prior to biopsy for all men, without previous history of biopsy, under consideration for prostate biopsy.


• There is currently insufficient evidence to recommend MRI for screening, staging or surveillance of prostate cancer.

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To read the old guideline, follow the link: https://doi.org/10.1016/j.juro.2017.04.101

The updated guideline titled, "Update of the AUA Policy Statement on the Use of Multiparametric Magnetic Resonance Imaging in the Diagnosis, Staging and Management of Prostate Cancer," is published in the Journal of Urology.

DOI: https://doi.org/10.1097/JU.0000000000000617