JAMA

Streamlined MRI matches standard in prostate cancer detection

September 15, 2025

Biparametric MRI is noninferior to multiparametric MRI for detecting clinically significant prostate cancer, provided image quality is sufficient. Adoption of biparametric MRI could reduce scan time, eliminate gadolinium exposure, and increase global MRI capacity, potentially establishing it as a new standard of care for prostate cancer diagnosis.

Study details: The PRIME Diagnostic Clinical Trial (NCT04571840) was a prospective, multicenter, within-patient, noninferiority study enrolling 490 biopsy-naive men with suspected prostate cancer across 22 centers in 12 countries. All participants underwent both biparametric MRI (T2-weighted and diffusion-weighted sequences) and multiparametric MRI (adding dynamic contrast-enhanced [DCE] imaging). Radiologists first interpreted the biparametric MRI blinded to DCE, then re-evaluated after unblinding. Biopsies were performed if either MRI modality was suggestive of clinically significant cancer (Gleason Grade Group ≥2).

Results: Biparametric MRI detected clinically significant prostate cancer in 29.2% of men, compared with 29.6% with multiparametric MRI (difference, −0.4 percentage points; 95% confidence interval, −1.2 to 0.4; P = 0.50), meeting the predefined noninferiority margin of 5%. Detection rates for clinically insignificant cancer were also similar (9.2% vs 9.6%). Image quality was adequate in 99% of cases.

Source:

Ng ABCD; PRIME Study Group Collaborators, et al. (2025, September 10). JAMA. Biparametric vs Multiparametric MRI for Prostate Cancer Diagnosis: The PRIME Diagnostic Clinical Trial. https://pubmed.ncbi.nlm.nih.gov/40928788/