Abstract
Background
Multiparametric magnetic resonance imaging (MP-MRI) targeted biopsy has been shown to identify more clinically-significant cancers and reduce the detection of clinically-insignificant disease when compared to systematic biopsy; however, the wide-spread accessibility of MP-MRI is limited. A potential strategy for reducing the cost, study time, and contrast-associated risks associated with MP-MRI is elimination of the dynamic contrast-enhanced (DCE) sequence, relying instead on biparametric MRI (BP-MRI). BP-MRI has been shown to have a diagnostic accuracy and cancer detection rate that are equivalent to those of MP-MRI.
Methods
We modeled the potential cost of BP-MRI compared to MP-MRI to determine what cost savings would occur if DCE was eliminated from these studies.
Results
When controlled for a 45 min time window that allows for one full MP-MRI or three full BP-MRI studies, the BP-MRI 45 min gross profit is $1531.32. This is an increase in gross profit of $892.58 for the 45 min time window or $10,710.98 in a 9-h business day when performing BP-MRI compared to MP-MRI for prostate cancer detection.
Conclusions
BP-MRI has the potential to result in substantial cost benefit and increased access to MRI in the diagnostic workflow and risk-stratification of men being evaluated for prostate cancer when compared to conventional MP-MRI.
Key points
• Multiparametric magnetic resonance imaging (MP-MRI) has been shown to identify more clinically-significant cancers and reduce the detection of clinically-insignificant disease.
• Biparametric magnetic resonance imaging (BP-MRI) has diagnostic accuracy and cancer detection rates that are equivalent to those of MP-MRI.
• BP-MRI reduces cost, study time, and contrast-associated risk by eliminating the dynamic contrast-enhanced (DCE) sequence.
• BP-MRI has the potential to increase access to advanced imaging for men being evaluated for prostate cancer.
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Acknowledgements
The authors gratefully acknowledge the assistance and support of Verlon Salley, Jeff McGough, Kecia Turner and Kathy Dabbs from the University of Alabama at Birmingham Department of Radiology.
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Soroush Rais-Bahrami serves as a consultant to Philips/InVivo Corp, Genomic Health Inc, and Blue Earth Diagnostics. The remaining authors declare that they have no conflict of interest.
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Porter, K.K., King, A., Galgano, S.J. et al. Financial implications of biparametric prostate MRI. Prostate Cancer Prostatic Dis 23, 88–93 (2020). https://doi.org/10.1038/s41391-019-0158-x
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DOI: https://doi.org/10.1038/s41391-019-0158-x
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