Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Imaging Overuse in Low-Risk Prostate Ca Patients

Urol Oncol; 2019 Feb; Drangsholt, Walter, et al

Imaging overuse remains an issue for low- and intermediate-risk prostate cancer patients despite guideline recommendations, a new study found. Researchers sought to determine the frequency of positive radiologic findings in a cohort of veterans with low- and intermediate-risk prostate cancer during initial staging at VA New York Harbor Healthcare System from 2005 to 2015. They reviewed each patient’s prebiopsy prostate specific antigen (PSA), Gleason score, and clinical state. They found:

  • In the cohort, 414 men were classified as low- to intermediate-risk prostate cancer and underwent inappropriate stating imaging of 4,306 men diagnosed with prostate cancer.
  • 178 (43%) of the 414 men had additional follow-up imaging for positive findings.
  • The incidental finding rate was 10% and the false-positive rate was 38% for patients.
  • Only 5 (1%) patients had metastatic disease.


Drangsholt S, Walter D, Ciprut S, et al. Quantifying downstream impact of inappropriate staging imaging in a cohort of veterans with low- and intermediate-risk incident prostate cancer. Urol Oncol. 2019;37(2):145-149. doi:10.1016/j.urolonc.2018.11.022.