Prebiopsy MRI use among men getting a first prostate biopsy jumped from 14% in 2017 to 64% in early 2026, according to a study published Sept. 17 in JAMA Oncology that analyzed more than 505,000 biopsies at U.S. hospitals through the Epic Cosmos database.
The study, including researchers such as the UH Urology Institute’s lead clinical research biostatistician, Stephen Rhodes, tracked biopsies performed between January 2017 and June 2026. For men who had a prior negative biopsy — the group where evidence for MRI was established earliest — use climbed from 38% to 67% over the same stretch, according to the research.
Why the numbers moved so fast
Multiple randomized trials found that imaging the prostate first and then targeting suspicious lesions finds more of the aggressive cancers that matter, according to Medical Xpress.
Stephen Rhodes noted that the shift was genuinely rapid and that the timing tracks closely with the publication of major trials and the incorporation of their results into guidelines.
A third of first-time patients still skip the scan
Even at 64% adoption, roughly one in three men undergoing a first biopsy in early 2026 had no MRI beforehand, per the JAMA Oncology data. The researchers also found MRI use falling off in men with very high PSA levels and in men over 80 — a pattern Medical Xpress reported may reflect reasonable clinical judgment in some cases, but is worth examining rather than assuming.
Senior author Jonathan Shoag, M.D., chief of the Division of Urologic Oncology and director of the Prostate Cancer Program at UH, said the gap has been visible on the ground for years.
Insurance claims data versus the new hospital-record picture
The earlier estimate, drawn from insurance claims through 2022, put MRI use at only about 30% of biopsies. The new JAMA Oncology analysis, built from electronic health records across many health systems rather than claims data, puts first-biopsy MRI use more than double that by early 2026 — 64%. The two figures come from different data sources and different time windows, but together they suggest adoption accelerated substantially in the years after 2022.
What University Hospitals says it has built around the scan
University Hospitals has invested in rigorously tracking its MRI quality and performance, and how it relates to biopsy outcomes, he said, and has built workflows offering the transperineal approach with sedation to all patients, a technique the health system helped establish through clinical trials.
As Jonathan Shoag explained, the health system has worked to streamline the patient journey alongside expanded access to advanced prostate cancer diagnostics, helping patients move from concern to diagnosis and treatment through navigation, point-of-service scheduling, and improved access to care.
The study, formally titled Trends in Prebiopsy MRI Utilization for Prostate Cancer Detection, appears in JAMA Oncology with DOI 10.1001/jamaoncol.2026.3620.