To assess adoption of pre-biopsy prostate MRI in the United States and evaluate factors associated with MRI-Bx use. Prior reports have shown improved cancer detection with magnetic resonance image-guided prostate biopsies (MRI-Bx) vs. transrectal ultrasound-guided methods (TRUS-Bx). Population-based trends of their use and outcomes have not been previously characterized.
Using private insurance claims (2009-2015), we identified men who underwent prostate biopsy. Exposures were biopsy year and geographic region defined by metropolitan statistical area. Outcomes included biopsy type (MRI-Bx, TRUS-Bx, transperineal) based on procedure codes and cancer detection based on a new diagnosis for prostate cancer (ICD-9-CM 185). Hierarchical mixed-effects multivariable regression estimated odds of receiving MRI-Bx.
We identified 241,681 men (mean age 57.5±5.4 years) who underwent biopsy. MRI-Bx use rose rapidly (0.2% in 2009 to 6.5% in 2015, p<0.001). Overall, 3,429 men received MRI prior to biopsy, more commonly in metropolitan statistical areas (OR (odds ratio) 1.90, 95% CI 1.66-2.19). In 2015, nearly 18% of men with prior negative biopsy underwent a pre-biopsy MRI. Patients with prior negative biopsies were over four times more likely to receive MRI-guidance (vs. no prior, OR 4.63, 4.27-5.02) and had a greater chance of cancer detection with MRI-Bx (25.2% vs. 19.7% TRUS-Bx, p=0.010).
Among men undergoing prostate biopsy, pre-biopsy prostate MRI utilization was concentrated within urban areas and among patients with prior negative biopsies, where its use was associated with superior cancer detection compared to traditional TRUS-guided biopsies.
This research output has an Altmetric Attention Score of 15. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 11 April 2019.
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Altmetric has tracked 28,932,665 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 90th percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
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