A trial looking at using MRI to help diagnose prostate cancer (PRECISION)

Cancer type:

Prostate cancer

Status:

Results

Phase:

Phase 3

This trial used magnetic resonance imaging (MRI) before prostate biopsy to see if it is better at finding prostate cancer. 

It was for people who have been asked by their doctors to have a sample of cells taken from the prostate (prostate biopsy).

 

More about this trial

Prostate biopsies are used to diagnose prostate cancer. Usually the doctor passes a needle up the back passage to the prostate, using an ultrasound scan to guide them. This is called transrectal ultrasound guided biopsy (TRUS).

The doctor takes a sample of cells from the prostate that might contain cancer. Sometimes the biopsies can miss the cancer cells or not show how serious they are. 

This trial will look at whether an MRI scan called a multi parametric MRI (MP MRI) could show the prostate areas likely to have cancer. An MP MRI is a detailed MRI scan that uses an injection of dye (contrast medium Open a glossary item) into a vein to make the images clearer and can help to find cancer.

Doctors will use the information from the MRI scan to take the biopsies. If there is an area seen on the MRI scan that the doctors think could be cancer, they will take samples from there. If there is no suspicious area on the MRI, then no biopsy will be taken at all. This happens in about 3 out of 10 people (30%). This means that some can avoid having a biopsy. 

The main aim of this trial was to find out whether an MRI guided biopsy is as good as a TRUS biopsy at diagnosing prostate cancer. 

 

Summary of results

The trial team found that an MRI guided biopsy was better than a TRUS biopsy for diagnosing prostate cancer. 
 
This trial was open for people to join between February 2016 and October 2017. These results were published in 2018. 
 
About this trial
This was a phase 3 trial. 500 people joined this trial.
 
It was a randomised trial. Everyone was put into 1 of 2 groups.
  • 252 people had an MRI scan then targeted biopsy if needed
  • 258 people had a TRUS guided biopsy

In the MRI scan group if the results of the scan suggested prostate cancer was present then a targeted biopsy was taken. 
 
In this trial researchers were looking at clinically significant prostate cancers. A clinically significant cancer had a Gleason score Open a glossary item of greater than or equal to 3+4 (a Gleason sum of 7).
 
Results
The researchers found clinically significant cancer in:
  • 95 (38%) of the people in the MRI scan targeted biopsy group 
  • 64 (26%) of the people in the TRUS guided biopsy group

Quality of life
For quality of life at 1 day and 30 days after the biopsy there wasn’t much difference between the 2 groups.
 
Complications from the biopsy 
A month after the biopsy people in the MRI group reported fewer complications. 
 
The number of people who reported blood in the urine was:
  • 30 out of every 100 people (30%) in the MRI group
  • 60 out of every 100 people (60%) in the TRUS group
For blood in the semen it was:
  • 32 out of every 100 people (32%) in the MRI group
  • 60 out of every 100 people (60%) in the TRUS group
For pain at the site of the procedure it was:
  • 13 out every 100 people (13%) in the MRI group
  • 23 out of every 100 people (23%) in the TRUS group
For bleeding from the back passage (rectum) it was:
  • 14 people out of every 100 people (14%) in the MRI group
  • 22 people out of every 100 people (22%) in the TRUS group
For problems getting an erection (erectile dysfunction) it was:
  • 11 out of every 100 people (11%) in the MRI group
  • 16 out of every 100 people (16%) in the TRUS group
The team said these findings showed that for every 100 people having a biopsy there were fewer in the MRI group than the TRUS group. 
 
2 out of every 100 people (2%) in both groups had a serious side effect. 
 
Conclusion
The team concluded to diagnose prostate cancer an MRI scan to assess the risk followed by an MRI targeted biopsy is superior to TRUS guided biopsy.  
 
Where this information comes from
We have based this summary on information from the research team. The information they sent us has been reviewed by independent specialists (peer reviewed Open a glossary item) and published in a medical journal. The figures we quote above were provided by the trial team who did the research. We have not analysed the data ourselves.

Recruitment start:

Recruitment end:

How to join a clinical trial

Please note: In order to join a trial you will need to discuss it with your doctor, unless otherwise specified.

Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Chief Investigator

Professor Caroline Moore
Professor Mark Emberton

Supported by

NIHR Clinical Research Network: Cancer
University College London (UCL)
UCL Surgical and Interventional Trials Unit
NIHR Doctoral Research Fellowship
European Association of Urology Research Foundation (EAU RF)

 

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Freephone 0808 800 4040

Last review date

CRUK internal database number:

13306

Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Keith took part in a trial looking into hormone therapy

A picture of Keith

"Health wise I am feeling great. I am a big supporter of trials - it allows new treatments and drugs to be brought in.”

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