ArticleCancer medicine2021
Cost-effectiveness of multiparametric magnetic resonance imaging and MRI-guided biopsy in a population-based prostate cancer screening setting using a micro-simulation model.
Article in Cancer medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.
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Who cites it
11 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Systematic Review on the Cost Effectiveness of Prostate Cancer Screening in Europe.European urology · 2024Pooled it
- MRI software and cognitive fusion biopsies in people with suspected prostate cancer: a systematic review, network meta-analysis and cost-effectiveness analysis.Health technology assessment (Winchester, England) · 2024Pooled it
- Prostate MRI versus PSA screening for prostate cancer detection (the MVP Study): a randomised clinical trial.BMJ open · 2022Trial
- Prostate cancer screening with MRI: insights from the ESUR Prostate MRI Working Group.European radiology · 2026Review
- An innovative approach for predicting prostate cancer Gleason grading: machine learning-based fusion of multimodal ultrasound, clinical and laboratory indicators.European journal of medical research · 2025Article
- Standardizing Prostate MRI Reporting in Active Surveillance for Prostate Cancer: The PRECISE Framework.Journal of the Korean Society of Radiology · 2025Review
- Review
- EpiSwitch PSE Blood Test Reduces Unnecessary Prostate Biopsies: A Real-World Clinical Utility Study.Cancers · 2025Article
- Post-Treatment Imaging in Focal Therapy: Understanding TARGET and PI-FAB Scoring Systems.Diagnostics (Basel, Switzerland) · 2025Review
- Prostate cancer screening-stepping forward with MRI.European radiology · 2023Article
- Cost-effectiveness of Prostate Cancer Screening Using Magnetic Resonance Imaging or Standard Biopsy Based on the STHLM3-MRI Study.JAMA oncology · 2022Article
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3 authors.
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Abstract
backgroundThe introduction of multiparametric magnetic resonance imaging (mpMRI) and MRI-guided biopsy has improved the diagnosis of prostate cancer. However, it remains uncertain whether it is cost-effective, especially in a population-based screening strategy.
methodsWe used a micro-simulation model to assess the cost-effectiveness of an MRI-based prostate cancer screening in comparison to the classical prostate-specific antigen (PSA) screening, at a population level. The test sensitivity parameters for the mpMRI and MRI-guided biopsy, grade misclassification rates, utility estimates, and the unit costs of different interventions were obtained from literature. We assumed the same screening attendance rate and biopsy compliance rate for both strategies. A probabilistic sensitivity analysis, consisting of 1000 model runs, was performed to estimate a mean incremental cost-effectiveness ratio (ICER) and assess uncertainty. A €20,000 willingness-to-pay (WTP) threshold per quality-adjusted life year (QALY) gained, and a discounting rate of 3.5% was considered in the analysis.
resultsThe MRI-based screening improved the life-years (LY) and QALYs gained by 3.5 and 3, respectively, in comparison to the classical screening pathway. Based on the probabilistic sensitivity analyses, the MRI screening pathway leads to total discounted mean incremental costs of €15,413 (95% confidence interval (CI) of €14,556-€16,272) compared to the classical screening pathway. The corresponding discounted mean incremental QALYs gained was 1.36 (95% CI of 1.31-1.40), resulting in a mean ICER of €11,355 per QALY gained. At a WTP threshold of €20,000, the MRI screening pathway has about 84% chance to be more cost-effective than the classical screening pathway.
conclusionsFor triennial screening from age 55-64, incorporation of mpMRI as a reflex test after a positive PSA test result with a subsequent MRI-guided biopsy has a high probability to be more cost-effective as compared with the classical prostate cancer screening pathway.
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