Increased Utilization of MRI Prior to Prostate Biopsy Observed in Recent Study

A significant rise in the use of magnetic resonance imaging (MRI) prior to prostate biopsy has been documented by researchers at University Hospitals, as reported in a study published in JAMA Oncology. Analysis of data from over 505,000 prostate biopsies at US hospitals, spanning from January 2017 to June 2026, highlighted this trend using information from Epic Cosmos, a comprehensive database derived from electronic health records.

The study indicates that prebiopsy MRI usage among men undergoing their first prostate biopsy increased dramatically from 14% in 2017 to 64% in the first half of 2026. Similarly, MRI utilization among men with a previously negative biopsy rose from 38% to 67%. Stephen Rhodes, a leading clinical research biostatistician at the UH Urology Institute, attributes this rapid alteration to the publication of major trials and subsequent integration of their findings into clinical guidelines.

Despite these advancements, a notable percentage—approximately one-third—of men still do not receive an MRI before a first biopsy. Senior author Dr. Jonathan Shoag, Chief of the Division of Urologic Oncology at UH, emphasizes the importance of assessing MRI appropriateness, as it impacts both the decision to proceed with a biopsy and the precise targeting during the procedure. Dr. Shoag notes, “Any man facing a biopsy should be asking whether an MRI is appropriate for him, because it changes both whether a biopsy is needed and where the needles go.”

The research showed a decrease in MRI usage among men with very high PSA levels and those over 80, which may reflect appropriate clinical judgment but warrants further examination to ensure consistent care quality. Dr. Shoag highlights persistent issues with MRI accessibility and quality, as well as ongoing efforts at University Hospitals to address these through rigorous tracking and adoption of advanced techniques such as transperineal biopsy approaches.

University Hospitals’ dedication to improving diagnostic pathways includes enhanced patient navigation and access initiatives. These efforts aim to streamline the journey from initial elevated PSA level detection through to diagnosis and potential treatment, if needed. This integrated approach seeks to facilitate timely and accurate prostate cancer diagnoses while optimizing patient experience and outcomes.

The study underscores the continuing need for healthcare systems to audit and enhance MRI utilization rates to bridge existing quality gaps in prostate cancer diagnostics.