ArticleEuropean urology open science2025
A Comparison of Magnetic Resonance Imaging Assessment and Biopsy Outcomes with and Without Central Review in Two Swedish Regional Organized Prostate Cancer Testing Programs.
Article in European urology open science, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Ongoing and completed clinical trials on prostate cancer screening using MRI.European radiology · 2026Review
- Impact of central review and MRI image quality on prostate cancer diagnosis and biopsy decision-making in referred patients.Abdominal radiology (New York) · 2026Article
- Comparison of software vs. cognitive-based fusion-targeted biopsies for prostate cancer diagnosis.BJUI compass · 2026Article
- Reference standards in AI-assisted MRI readings in prostate cancer screening: primetime for benchmarking.European radiology · 2026Article
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Authors and funding
6 authors.
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No grant is acknowledged in the PubMed record.
Abstract
Background and objective: The European Council advises evaluating the feasibility of organized prostate cancer testing (OPT) programs, but it is unclear whether results from screening trials can be replicated in population-based testing. The aim of this study is to compare magnetic resonance imaging (MRI) assessments and biopsy outcomes with and without a central review in two Swedish OPT programs. Methods: Two regional population-based OPT programs invited 65 000 men (2020-2022). MRI scans were read locally, and biopsies followed a strict MRI-based and prostate-specific antigen (PSA) density-based protocol. A blinded central review was done by two radiologists with 8 and 9 yr of experience. Reader agreement was assessed with percentages and kappa scores. Positive predictive values (PPVs) for detecting grade group (GG) 2-5 prostate cancer were calculated with 95% confidence intervals (CIs). Key findings and limitations: MRI scans for 416 men (median age 52 yr) with PSA ≥3 ng/ml were evaluated. In Skåne, 27% of scans were primarily assigned Prostate Imaging Reporting and Data System (PI-RADS) scores ≥4, compared with 10% in Västra Götaland. At the primary reading, 76 men had PI-RADS ≥4, yielding 43 GG 2-5 prostate cancer cases: PPV 0.57 (95% CI 0.45-0.67). At the central review, 65 men had PI-RADS ≥4. Out of 61 men biopsied, 50 had GG 2-5 prostate cancer: PPV 0.82 (95% CI 0.71-0.90, Conclusions and clinical implications: In population-based screening with local MRI reading, MRI assignment may vary substantially. Centralized reading could reduce these differences and increase the biopsy PPV for GG ≥2 cancer. Patient summary: In this report, we reviewed local magnetic resonance imaging (MRI) reading in population-based screening. We found that MRI assignment varied between centers. We conclude that centralized reading could reduce differences and improve biopsy outcomes.
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