What’s next?
Dr. Klotz noted that an important addition to PRECISE is the planned follow-up of patients who did not receive treatment on study.
“We know MRI is not perfect, so what happens to the guys who avoid the biopsy? How much at risk are they of having something missed? So the only way to know that really is with long-term follow-up on the patients,” he said in an interview.
In addition to repeating MRI at 2 years, the investigators plan to follow these patients for up to 8 years.
“But certainly, compared to the traditional strategy of systematic biopsy, this looks a lot better,” Dr. Klotz commented.
In his editorial, Dr. Rouvière commented that the intersite variability seen in the study “sounds like a warning to the MRI pathway.”
“Considering that all participating centers were experienced high-volume tertiary centers, the intersite variability is probably much higher among less experienced centers,” he wrote. “Thus, whatever the diagnostic pathway, continuing education and quality insurance programs will become major issues in the future, not only for prostate MRI interpretation, but also for targeted biopsy, which does have a learning curve, even with magnetic resonance and ultrasound fusion systems, and even for systematic biopsy.”
PRECISE was funded by the Ontario Institute of Cancer Research and Prostate Cancer Canada. Dr. Klotz and Dr. Rouvière have disclosed no relevant financial relationships.
A version of this article first appeared on Medscape.com.