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Scans halve prostate biopsies

Body scans: Urologists are pushing Australian health authorities to fund MRIs for prostate checks on Medicare. Picture: Iain Gillespie/The West Australian

MRI scans could radically change the diagnosis and treatment of prostate cancer and halve the number of unnecessary biopsies, an international expert has told doctors in Perth.

Jelle Barentsz, from the University Medical Centre Nijmegen in the Netherlands, said the use of magnetic resonance imaging could also be tweaked to track down tiny cancers while they were more treatable.

Professor Barentsz has been brought to Perth by the WA Clinical Oncology Group to speak to GPs, urologists and radiologists about findings from a trial using scans known as multiparametric MRIs in men with raised prostate specific antigen levels.

PSA testing is controversial because many men with raised levels who have biopsies are found to not have prostate cancer or are found with insignificant tumours that are sometimes treated unnecessarily, resulting in side effects such as impotence.

Urologists are pushing Australian health authorities to fund MRIs for prostate checks on Medicare.

Professor Barentsz said a major advantage of MRIs was that they were able to accurately pick up so-called "significant" cancers, not the unimportant ones that many men tended to have into old age.

The international trial found MRI reduced the detection of insignificant tumours 90 per cent, and missed 5 per cent of significant cancers compared with the current 20 per cent missed by "blind biopsies" where needles are placed randomly in the prostate to look for cancer cells.

"If a man goes to a urologist and an insignificant cancer is found, he will worry about it and often will have his prostate removed or have radiation therapy, potentially leading to overtreatment," Professor Barentsz said.

"But if an MRI is done and comes back normal, it avoids unnecessary biopsies."

Perth urologist Tom Shannon said many patients were now asking for an MRI before a biopsy was done.