MRI used for prostate cancer diagnosis allows better treatment planning

Man about to undergo an MRI – Image generated by WIX AI

CANCER DIGEST – April 5, 2026 – A systematic review of more than 40 studies showed that using magnetic resonance imaging (MRI) in the diagnosis of prostate cancer can significantly improve the ability to predict long-term outcomes for prostate cancer patients undergoing radical prostatectomy.

The analysis of previously published clinical trials was led by Georgios Argotis, MD, PhD of the Netherlands’s Cancer Institute in Amsterdam and published online in the April 2, 2026 journal JAMA Oncology. 

The researchers looked at data from 40 studies involving nearly 25,000 patients with prostate cancer in various stages. They found that when MRI was used to diagnose prostate cancer that had broken through the outer  membrane of the prostate, called mrT3a disease, there was a greater risk of biochemical recurrence, meaning cancer recurrence induced by hormones, a greater chance of metastatic failure, meaning the cancer would spread to other tissues, and a greater risk of dying specifically  of prostate cancer.

When they looked at prostate cancer that had invaded the seminal vessels (mrTb disease) they found similar elevated risk of hormone induced recurrence, cancer spread, and risk of dying of prostate cancer in men undergoing prostatectomy.

The researchers wrote that while conventional risk evaluation models based on prostate-specific antigen (PSA), digital rectal exam, and biopsy Gleason grade provide a useful foundation for appropriate risk assessment, they only partially capture important tumor characteristics, for example size, location, and how conspicuous the tumor is. By adding MRI to the diagnostic process, the researchers say clinicians can have a much more complete picture of their patients’ disease.

The researchers concluded that there is a need for MRI-derived parameters that can refine prognostic estimates in prostate cancer beyond traditional clinical variables.

In a accompanying commentary, however, Nicholas Pickersgill, MD of Washington University School of Medicine, St. Louis, said that a crucial next step would be prospective validation. Even so, as conventional diagnostics continue to refine prognostic estimates the added value of MRI may diminish.

Sources: JAMA Oncology