MRI for prostate cancer screening: ESUR working group insights

MRI-based prostate cancer screening detects more clinically significant cancer and reduces unnecessary biopsies; biparametric MRI is recommended as the protocol of choice, though long-term mortality data are lacking.

• Two implementation strategies exist: MRI-first pathways (maximize detection) and risk-stratified approaches (e.g., MRI after PSA), which are more feasible.
• Barriers include limited MRI capacity, costs, and need for standardization; AI may improve efficiency.
• Long-term outcomes including mortality impact and interval cancer rates remain uncertain.

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