Trends and Predictors of Ultrasound-Guided MRI Biopsy for Prostate Cancer Diagnosis in the U.S.

Multiparametric magnetic resonance imaging (MRI) is recommended before prostate biopsy to improve the detection of clinically significant prostate cancer (PCa) beyond traditional transrectal ultrasound-guided methods. This study aimed to analyze trends and factors influencing the adoption of MRI-guided prostate biopsies (MRI-Bx) across the United States. Using the Marketscan Database (Commercial and Medicare Claims), researchers reviewed cases from 2012 to 2021, identifying 256,961 men who had a prostate MRI within nine months before a biopsy. Patients with previous diagnoses, treatments, or PCa metastasis prior to biopsy were excluded to focus on new diagnostic patterns. The study revealed that by 2021, MRI-Bx was performed on 27.04% of biopsy-naive, commercially insured patients and 61.85% of those who had prior biopsies. For Medicare patients, MRI-Bx accounted for 27.14% of biopsy-naive cases and 51.89% of those with a biopsy history. Over the study period, MRI-Bx utilization increased twentyfold. Key predictors of MRI-Bx included prior biopsy history, which made men six times more likely to undergo MRI-Bx (Odds Ratio (OR): 6.07, 95% Confidence Interval (CI): 5.25–7.03, p<0.001), and residence in metropolitan areas, associated with nearly double the likelihood of MRI-Bx usage (OR: 1.95, CI: 1.67–2.28, p<0.001). Interestingly, MRI-Bx use was not significantly influenced by insurance type (Medicare vs. commercial) or deductible level (high vs. low). These findings underscore a substantial increase in MRI-Bx adoption, particularly among men with prior biopsy experience or those residing in urban areas, while insurance coverage factors appeared to have minimal impact. This trend points to growing acceptance of MRI-Bx for enhancing prostate cancer detection in at-risk populations.