Originally published: 2021 | Updated: March 2026
Reading Time: 4 minutes
Medically reviewed on: March 20th 2025. Dr Christos Mikropoulos Consultant Clinical Oncologist MBBS, MSc, MD (Res), MRCP, FRCR GMC: 4692210
Authors: Ms Clare Delmar. The Focal Therapy Clinic
At a Glance
Prostagram is an MRI-based prostate screening technique developed by researchers at Imperial College London that detected twice as many clinically significant prostate cancers as the standard PSA blood test in a trial of over 400 men. If validated in larger trials, Prostagram could become the routine screening tool for prostate cancer — just as mammography is for breast cancer — enabling earlier diagnosis and more precise, tissue-preserving treatments such as focal therapy.
- Twice the detection rate — Prostagram identified double the clinically significant cancers compared to PSA testing alone
- Reduces over-diagnosis — MRI-based screening better distinguishes significant from insignificant disease, sparing men unnecessary biopsies and treatments
- Inclusive trial design — 32.4% of participants were black men, reflecting higher prostate cancer risk in this demographic
- Larger trial planned — A 20,000-man study is in development to validate findings for population-level screening
- Complements focal therapy — Earlier, image-based detection strengthens the pathway toward precision treatments like HIFU (NICE IPG424) and NanoKnife IRE (NICE IPG768)
What Is Prostagram and How Does It Work?
Prostagram is an MRI-based prostate cancer screening technique developed by researchers at Imperial College London that detected twice as many clinically significant cancers as the standard PSA blood test in a trial of over 400 men. If validated at population scale, it could become the routine screening equivalent of the mammogram for men — enabling earlier diagnosis and more targeted treatment through focal therapy.
At The Focal Therapy Clinic, we often describe focal therapy as the “male lumpectomy”, comparing advancements in targeted treatment for breast cancer to those now available for the prostate. The development of Prostagram extends this comparison from treatment to screening — potentially transforming how prostate cancer is detected in the general population.
According to the investigators at Imperial College London:
“The prospect of a male equivalent of the breast mammogram or so-called ‘prostagram’ has been a long-standing goal in prostate cancer diagnostics. Image-based screening has been adopted for other common cancers including mammography for breast cancer and low-dose CT for lung cancer screening. TRUS was touted as the original ‘male mammogram’ in the 1990s but did not prove to be effective as an independent test. The revolution of MRI has offered a new opportunity to re-explore this area. If the performance characteristics of a standard mpMRI can be replicated in the general population, this would address some of the issues with PSA as a screening test.”
While multiparametric MRI (mpMRI) has become the standard of care for prostate cancer diagnostics — as recommended by NICE Guideline NG131 — it has not yet been adapted for population-level screening. Screening targets people without current symptoms, while diagnostics are for people with symptoms suspicious of cancer. Regular screening coupled with rapid diagnostic testing helps ensure cancer is caught early, giving patients the best chance of successful treatment.
How Did the Prostagram Study Perform?
The Imperial College London team tested Prostagram in a study of over 400 men across the UK, comparing different approaches to scanning the prostate using MRI and optimising the scoring technique. The results showed that Prostagram detected twice as many clinically significant prostate cancers compared to the standard PSA blood test alone.
Key study details:
- Study size — over 400 men aged 50-69 across the UK
- Diversity — 32.4% of participants were black men, who are at increased risk of prostate cancer
- Detection rate — Prostagram identified twice as many clinically significant cancers as PSA testing
- Study period — October 2018 to May 2019
All participants were invited for prostate cancer screening using both Prostagram and established methods from October 2018 to May 2019. The results were significant: Prostagram detected twice as many clinically significant prostate cancers compared to the standard PSA (prostate-specific antigen) blood test.
“A major achievement for the trial was the recruitment of ethnic minority and lower socio-economic participants broadly equivalent to their proportion within the community, which could be replicated in future general population screening trials.”
How Does Prostagram Compare to PSA Testing?
| Feature | PSA Blood Test | Prostagram (MRI Screening) |
|---|---|---|
| Detection method | Blood protein level | MRI imaging of prostate |
| Significant cancer detection | Baseline | 2x higher than PSA |
| Over-diagnosis risk | High (detects insignificant disease) | Lower (distinguishes significant from insignificant) |
| Invasiveness | Blood draw | Non-invasive scan |
| Current status | Widely available | In clinical trials |
Source: Imperial College London Prostagram study, JAMA Oncology, 2021
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What Could Prostagram Mean for Prostate Cancer Screening?
A larger validation trial involving 20,000 men is in development. If results confirm or improve upon the initial findings, there will be a clear pathway toward implementing Prostagram as a population-level screening programme — much as mammography is used for breast cancer.
The implications are significant for men’s health: MRI-based screening could reduce both under-diagnosis (missing significant cancers) and over-diagnosis (detecting clinically insignificant disease that does not need treatment). For men found to have localised prostate cancer through earlier, image-based detection, precision treatments such as focal therapy — including HIFU (NICE-approved under IPG424) and NanoKnife IRE (NICE IPG768) — offer cancer control with 90%+ sexual function preservation and 97% urinary continence (FTC audit, n=265).
What Do FTC Consultants Say About Prostagram?
The Focal Therapy Clinic team sees Prostagram as a significant advance in the prostate cancer pathway. Mr Tim Dudderidge, Consultant Urological Surgeon (FRCS(Urol), GMC: 4505451), foresees benefits for both detection and treatment planning:
“The Prostagram study opens up a new chapter in the screening, diagnostic and treatment pathway for prostate cancer. Precision screening will improve the detection process — increasing diagnosis of clinically significant disease and reducing unnecessary detection of insignificant disease. It’s likely that focal therapy will emerge as a preferred alternative to surgery and radiotherapy for many men with localised prostate cancer. The other exciting consequence of an image-based screening programme could be the acceleration of AI-supported reporting systems for both MRI and pathology, providing the framework for radiologists and pathologists to deliver image-based reports to guide treatment planning.”
With over 2,000 focal therapy procedures performed collectively, The Focal Therapy Clinic’s consultants are well-positioned to treat the earlier-stage, localised cancers that improved screening would identify. In the clinic’s one-year outcome audit of 265 patients, 90% remained cancer-free at 12 months with 90%+ sexual function preservation and 97% urinary continence.
Mr Alan Doherty, Consultant Urological Surgeon (FRCS(Urol), GMC: 3279241) and Director of the Birmingham Prostate Clinic, sees Prostagram as a boost for precision treatment that challenges the role of Active Surveillance:
“The adoption of Prostagram will increasingly reinforce the acceptance of focal therapy. When target lesions are identified early and become more precisely defined as the diagnostic pathway unfolds, a non-invasive curative treatment becomes the natural next step — rather than asking men to live with the anxiety of ongoing monitoring.”
What Should You Do Next?
While Prostagram is not yet available as a routine screening tool, the current standard of care already uses multiparametric MRI (mpMRI) as the first-line diagnostic investigation for men with suspected prostate cancer, as recommended by NICE Guideline NG131. Over the past decade, mpMRI has transformed the prostate cancer diagnostic pathway — and integrating MRI-based imaging into population screening would complete that transformation.
If you have concerns about prostate cancer or have received abnormal PSA results, The Focal Therapy Clinic offers expert MRI assessment and, where appropriate, focal therapy treatment options including HIFU (NICE IPG424) and NanoKnife IRE (NICE IPG768). Our consultants have collectively performed over 2,000 procedures across seven UK locations, with 90% of patients cancer-free at 12 months (FTC audit, n=265).
To book a consultation, call 0207 036 8870 or contact us online.
