17th Jun 2026
PRISM Consensus Defines MRI Standards for Prostate Cancer Screening
BSUR is happy to support the Prostate Imaging Standards for Screening MRI (PRISM) recommendations recently published in JAMA Oncology.
This international consensus effort establishes the first detailed recommendations for the applications of MRI in prostate cancer screening.
21 international experts, including radiologists, urologists and pathologists reviewed prior prospective screening studies comprising 1,426 men who underwent upfront MRI. Most used non-contrast 3T MRI, with pooled detection rates of 6.0% for clinically significant (Grade Group ≥2) prostate cancer and 1.4% for GG1 disease.
Of particular relevance, PRISM recommends MRI screening protocols should be: -
- Biparametric, comprising single plane T2-weighted and DWI only (no T1 or DCE) -
- Performed at 1.5T or 3T, provided minimum technical standards are met -
- Acquisition times should not exceed 15 minutes -
NB: Routine bowel preparation techniques or antispasmodics are not recommended as they disrupt workflows and increase screening costs
The consensus endorsed a novel “stage-gated” reporting approach. Initial assessment is limited to axial T2-weighted and high b-value DWI images, with full review of the remaining sequences and planes only if a concordant focal abnormality is identified. This strategy aims to reduce indeterminate findings and unnecessary biopsy recommendations while preserving the detection of clinically significant cancers.
The panel emphasised that screening MRI should be performed only in accredited centres and interpreted by dedicated prostate MRI specialists meeting defined experience thresholds. Robust quality assurance, reader certification and ongoing audit are considered essential prerequisites for implementation.
Moving forward, the PRISM recommendations provide an important framework for standardising MRI acquisition, interpretation and reporting for future prostate cancer screening trials and programmes.
Reference: Mayor N, et al. Prostate Imaging Standards for Screening Magnetic Resonance Imaging (PRISM): International Consensus Recommendations. JAMA Oncology. Published online 11 June 2026.
Open Access:
https://jamanetwork.com/journals/jamaoncology/fullarticle/10.1001/jamaoncol.2026.1711