Wat een beginnend medisch student moet weten! What a beginning medical student should know!

Barentsz: “Because they see the real value of MRI for their patients. In 2012, I introduced a new international standard for prostate MRI. It enables earlier and more accurate detection of aggressive prostate cancer, with far fewer biopsies. MRI has truly been a gamechanger in prostate cancer diagnostics.”

Barentsz: “Yes, that’s mine. I’ve long opposed unnecessary and painful procedures. The traditional approach involved 12 biopsy samples taken through the rectum—painful and potentially causing infections. Now, an MRI is done first. If the MRI is shows no cancer, no biopsy is needed. This avoids about 1 million unnecessary biopsies worldwide every year. And, if something suspicious shows up, we can target it precisely under MRI-Ultra-Sound guidance.”

Barentsz: “Urologists prioritize patient care. Trusting new imaging techniques takes time, especially when it changes standard practice. That’s understandable. But we’ve provided solid scientific evidence. We’ve convinced the European and American guideline committees, and now prostate MRI is included in both the European and Dutch guidelines: every man with elevated PSA or suspicion of cancer should get an MRI before biopsy.”

“Because the population is aging and more men are aware of their prostate and PSA levels, urologists are seeing too many new patients, which is hard for them to manage. A structured, risk-based approach-starting with PSA testing, then checking PSA density, and using a prostate MRI if results are abnormal-will make the diagnostic process more consistent and help reduce the workload for urologists.”

Barentsz: “Great question. Ask someone with kidney stones and someone with elevated PSA—you’ll get different answers! But seriously, I’m deeply honored to be recognized alongside Professor Wickham. It underlines how crucial accurate diagnosis is and recognizes the vital role of radiology.”

Barentsz: “Ideally, every man with elevated PSA should quickly receive a high-quality MRI, without delay or resistance. A normal MRI can immediately relieve anxiety. If the MRI is suspicious, targeted biopsy should follow swiftly. If cancer is confirmed, additional imaging—like PSMA PET/CT or even nano-MRI—can guide treatment.

This entire diagnostic pathway is already standard at many places, and supported by the guidelines. Studies show it is not only more accurate but also cost-effective. However, policy implementation still lags. Inclusion of MRI in the guideline is a big step forward—it supports urologists and paves the way for better agreements with insurers.

Now, we need to focus on training and quality assurance, so every man receives the best diagnostic care possible. With a fantastic team from the Dutch Radiology Society, in close collaboration with urologists and the Prostate Cancer Foundation, we are working hard to meet these challenges.”