NICE approval to use MRI for prostate cancer diagnosis welcomed by UCL
12 December 2018
The decision by the National Institute for Health and Care Excellence (NICE) to recommend that all men at risk of prostate cancer receive an MRI scan ahead of a biopsy, has been welcomed by the UCL researchers, who led the trials which supported the recommendation.
Draft guidance published by NICE today (12/12/2018) approves multiparametric MRI (mpMRI) as a first line investigation for men suspected of having clinically localised prostate cancer.
The cutting edge technology can produce a detailed image of the prostate which can help specialists decide whether a biopsy is needed.
For those men at very low risk of cancer, this type of imaging can prevent unnecessary biopsies which can be unpleasant and have a risk of infection.
The scan has also been recommended as an option for people who have active surveillance to monitor the cancer.
The decision by NICE, follows two clinical trials (PROMIS and PRECISION) led by UCL in partnership with University College London Hospitals (UCLH).
Following the announcement, UCL’s Dean of Medical Sciences, Professor Mark Emberton, who oversaw both the trials, said:
“This recommendation by NICE is fantastic news and means all men at risk of prostate cancer will now have an MRI scan before any biopsy - bringing to an end to the post-code lottery that currently exists in the UK in terms of MRI provision.
“We have been using MRI for men at risk of prostate cancer at UCL and UCLH for a decade, and it is heartening to see our research has come to full fruition with this unequivocal guidance, meaning all men will now get access to this cost-effective and transformative technology.
“Our PROMIS and PRECISION studies have shown MRI scans will result in fewer unnecessary invasive biopsies for men, and fewer important cancers missed.”
He added: “MRI for all men prior to biopsy of the prostate is the most important development in the management of men with early prostate cancer that we have had in the last 100 years.
“The UK has led the evidence gathering for MRI in men at risk of prostate cancer and it is great to see the UK being the first country to make a formal recommendation that it should be used in all men prior to a biopsy.”
Professor Caroline Moore (UCL Division of Surgery and Interventional Medicine), who led the PRECISION trial, said: “High quality MRI before biopsy allows doctors to safely reassure men at lowest risk, and identify men most likely to benefit from treatment. The challenge now is to ensure the availability of high quality MRI across the NHS.”
Approximately 130 new prostate cancer cases are diagnosed in the UK every day and in 2016 alone, 11,631 people died from the disease. Advances in imaging technology have already led to changes in current practice across the country following the need for better diagnostic tools.
Multiparametric MRI is clinically cost effective as it will reduce the number of biopsies performed. Additionally, cancers are more likely to be detected and identified earlier therefore reducing the need for further treatment.
Health economic evidence shows that MRI-influenced prostate biopsy may be more cost effective than systematic prostate biopsy as it takes less time and is more efficient in identifying clinically significant cancer.
Paul Chrisp, Director for the NICE Centre for Guidelines said: “This diagnostic pathway will hopefully improve survival, reduce unnecessary surgery and benefit both patients and the NHS in the long term.
“We are pleased to announce that we will be recommending multiparametric MRI for patients with prostate cancer. This diagnostic method aims to improve survival, reduce unnecessary biopsies and benefit both patients and the NHS in the long term.”
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