Prof. Nicolaas Lumen
(28 June 2017)
Biomarkers and multiparametric MRI are not competitors of each other. A biomarker is an objective biological test, whereas an MRI is an anatomical estimation of the prostate. This is a subjective interpretation with inter-observer and even intra-observer variability. Contra-indications for MRI should also be taken into account [allergies to the contrast agent, non-MRI compatible implants, and claustrophobia]. People that are not able to undergo an MRI, will need a biomarker test to determine the likelihood of finding clinically significant prostate cancer upon biopsy.
You should use the test with the best accuracy, which will probably be a good biomarker
The biomarker test can be used for screening or triage. If the likelihood of finding clinically significant prostate cancer is high, an MRI-targeted biopsy can be performed subsequently. [If low, there is only a very small risk of missing clinically significant prostate cancer with the new generation biomarker tests.]