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Trends in pre-biopsy MRI usage for prostate cancer detection, 2007–2022

Prostate Cancer and Prostatic Diseases volume 28, pages 519–522 (2025)Cite this article

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Abstract

Background

Clinical guidelines favor MRI before prostate biopsy due to proven benefits. However, adoption patterns across the US are unclear.

Methods

This study used the Merative™ Marketscan® Commercial & Medicare Databases to analyze 872,829 prostate biopsies in 726,663 men from 2007–2022. Pre-biopsy pelvic MRI within 90 days was the primary outcome. Descriptive statistics and generalized estimating equations assessed changes over time, urban-rural differences, and state-level variation.

Results

Pre-biopsy MRI utilization increased significantly from 0.5% in 2007 to 35.5% in 2022, with faster adoption in urban areas (36.1% in 2022) versus rural areas (28.3% in 2022). Geographic disparities were notable, with higher utilization in California, New York, and Minnesota, and lower rates in the Southeast and Mountain West.

Conclusions

The study reveals a paradigm shift in prostate cancer diagnostics towards MRI-guided approaches, influenced by evolving guidelines and clinical evidence. Disparities in access, particularly in rural areas and specific regions, highlight the need for targeted interventions to ensure equitable access to advanced diagnostic techniques.

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Fig. 1: Temporal trends in pre-biopsy MRI for prostate cancer diagnosis in the United States, and in urban and rural areas, 2007–2022.
Fig. 2: Geographic trends in pre-biopsy MRI for prostate cancer diagnosis in the United States, 2007–2022.

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Funding

This work was supported by the Departments of Radiology and Urology at Stanford University and the National Cancer Institute of the National Institutes of Health under Award Number R37CA260346. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Attribution:Certain data were supplied by Merative as part of one or more MarketScan Research Databases. Any analysis, interpretation, or conclusion based on these data is solely that of the authors and not Merative. Data for this project were accessed using the Stanford Center for Population Health Sciences Data Core. The PHS Data Core is supported by a National Institutes of Health National Center for Advancing Translational Science Clinical and Translational Science Award (UL1TR003142) and from Internal Stanford funding.

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Author notes

  1. These authors contributed equally: Mirabela Rusu, Geoffrey A. Sonn.

Authors and Affiliations

  1. Department of Urology, Stanford University School of Medicine, Stanford, CA, USA

    Simon John Christoph Soerensen, Shufeng Li, Richard E. Fan, Mirabela Rusu & Geoffrey A. Sonn

  2. Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA, USA

    Simon John Christoph Soerensen & Marvin E. Langston

  3. Department of Dermatology, Stanford University School of Medicine, Stanford, CA, USA

    Shufeng Li

  4. Department of Radiology, Stanford University School of Medicine, Stanford, CA, USA

    Mirabela Rusu & Geoffrey A. Sonn

  5. Department of Biomedical Data Science, Stanford University, Stanford, CA, USA

    Mirabela Rusu

Authors
  1. Simon John Christoph Soerensen
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  2. Shufeng Li
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  4. Richard E. Fan
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  5. Mirabela Rusu
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Contributions

Conception and design: SJCS, SL, MR, GAS. Acquisition of data: SJCS, SL. Analysis and interpretation of data: SJCS, SL. Drafting of the manuscript: SJCS, SL, MEL, REF, MR, GAS. Critical revision of the manuscript for important intellectual content: SJCS, SL, MEL, REF, MR, GAS. Statistical analysis: SJCS, SL. Obtaining funding: MR, GAS. Administrative, technical, or material support: MR, GAS, SL. Supervision: MR, GAS

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Correspondence to Simon John Christoph Soerensen.

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Soerensen, S.J.C., Li, S., Langston, M.E. et al. Trends in pre-biopsy MRI usage for prostate cancer detection, 2007–2022. Prostate Cancer Prostatic Dis 28, 519–522 (2025). https://doi.org/10.1038/s41391-024-00896-y

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