{
  "abstract": "ObjectivesTo describe active surveillance (AS) outcomes following introduction of an MRI-informed pathway, examine whether baseline PI-RADS/Likert scores identify men with earlier AS discontinuation, and assess the acceptability of dietary fibre supplementation in men on AS.\n\nPatients and methodsWe conducted a retrospective audit of 420 men enrolled in AS at Aberdeen Royal Infirmary between 2012 and 2022. Men were grouped into an MRI-informed pathway (n=198) or biopsy-first pathway (n=222). Time to AS discontinuation for any reason was analysed using Kaplan-Meier methods and log-rank tests. An exploratory analysis compared men with baseline PI-RADS/Likert scores of 4-5 and 2-3. Ten men on AS also completed semi-structured interviews analysed using the Theoretical Framework of Acceptability.\n\nResultsMedian follow-up was 3.1 years (IQR 1.6-5.1). Overall, 208 men (49.5%) discontinued AS, including 176 because of disease progression. Median time to discontinuation was 4.9 years (95% CI 4.4-5.6). It was shorter in the MRI-informed pathway than in the biopsy-first pathway (4.1 vs 5.6 years; log-rank p<0.01). Among 167 men with recorded baseline MRI scores, 44 (26.3%) had PI-RADS/Likert 4-5. Median time to discontinuation was 2.9 years in this group compared with 4.0 years for scores 2-3 (p<0.01). Interview participants were generally willing to consider dietary fibre supplementation, although gastrointestinal effects and study procedures were anticipated burdens.\n\nConclusionAS discontinuation occurred earlier in the MRI-informed pathway, although differences in patient selection and surveillance practice should be considered when interpreting this finding. PI-RADS/Likert 4-5 identified a sizeable subgroup with earlier all-cause AS discontinuation that may help inform recruitment to future intervention studies. Dietary fibre supplementation was acceptable in principle, supporting further feasibility work.",
  "abstract_shown": true,
  "affiliations": [
    "The Rowett Institute, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK"
  ],
  "article_type": "PUBLISHAHEADOFPRINT",
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "name": "D. Sescu"
    },
    {
      "name": "J. Zbikowski"
    },
    {
      "name": "J. S. Royle"
    },
    {
      "name": "S. MacLennan"
    },
    {
      "affs": [
        0
      ],
      "name": "A. Kiltie"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/7mpwdj22g0jeq.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.09.24.26363863",
  "fulltext_url": "https://www.medrxiv.org/content/10.64898/2026.09.24.26363863v1.full",
  "id": "7mpwdj22g0jeq",
  "issns": [],
  "landing_url": "https://www.medrxiv.org/content/10.64898/2026.09.24.26363863v1",
  "language": null,
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "medrxiv",
      "oncology"
    ],
    [
      "openalex",
      "2740|Prostate Cancer Diagnosis and Treatment"
    ]
  ],
  "openalex": "W7214374390",
  "pdf_url": "https://www.medrxiv.org/content/10.64898/2026.09.24.26363863v1.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-09-24",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/7mpwdj22g0jeq.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:23Z",
      "native_id": "10.64898/2026.09.24.26363863",
      "source": "medrxiv",
      "url": "https://www.medrxiv.org/content/10.64898/2026.09.24.26363863v1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "medrxiv:oncology",
      "subfield": "oncology"
    }
  ],
  "title": "MRI-informed active surveillance outcomes and dietary fibre acceptability: the Aberdeen experience",
  "title_text": "MRI-informed active surveillance outcomes and dietary fibre acceptability: the Aberdeen experience",
  "type": "preprint",
  "updated_at": "2026-10-30T12:19:23Z",
  "url": "https://research.draconitic.com/paper/7mpwdj22g0jeq",
  "venue": "medRxiv",
  "versions": []
}