MRI Guided Prostate Biopsies Can Improve Care and Reduce Costs Interview with:

Vikas Gulani, MD, PhD Director, MRI, UH Cleveland Medical Center Associate Professor, Radiology, CWRU School of Medicine

Dr. Gulani

Vikas Gulani, MD, PhD
Director, MRI, UH Cleveland Medical Center
Associate Professor, Radiology, CWRU School of Medicine What is the background for this study? What are the main findings?

Response: We wanted to learn if performing MR before prostate biopsy, followed by MR guided strategies for biopsy, are cost effective for the diagnosis of prostate cancer in men who have not previously undergone a biopsy and who have a suspicion of prostate cancer.

The most significant findings are as follows:

We found that all three MR guided strategies for lesion targeting (cognitive targeting, MR-ultrasound fusion targeting, and in-gantry targeting) are cost effective, as the increase in net health benefits as measured by addition of quality adjusted life years (QALY), outweigh the additional costs according to commonly accepted willingness to pay thresholds in the United States.

Cognitive targeting was the most cost effective. In-gantry biopsy added the most health benefit, and this additional benefit was cost-effective as well. What should readers take away from your report?

Response: I think this is one more data point encouraging us as a medical community to consider adding MRI before biopsy to the care pathway of men with suspicion of prostate cancer. Is there anything else you would like to add?

Response: I would like to thank my co-authors Drs. Pahwa, Schiltz, Ponsky, and Griswold, as we are together a tremendous multi-disciplinary team. Drs. Pahwa and Schiltz did the heavy lifting on the project as co-first authors. Dr. Ponsky provided a incredibly important urology input on the management of these patients; without his help we could not have constructed the model that we needed for this paper.

My lab receives research support from Siemens Healthcare. Thank you for your contribution to the community.


Shivani Pahwa, Nicholas K. Schiltz, Lee E. Ponsky, Ziang Lu, Mark A. Griswold, Vikas Gulani. Cost-effectiveness of MR Imaging–guided Strategies for Detection of Prostate Cancer in Biopsy-Naive Men. Radiology, 2017; 162181 DOI: 10.1148/radiol.2017162181

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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