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Moving away from systematic biopsies: image-guided prostate biopsy (in-bore biopsy, cognitive fusion biopsy, MRUS fusion biopsy) —literature review

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Abstract

Objective

To compare the detection rate of clinically significant cancer (CSCa) by magnetic resonance imaging-targeted biopsy (MRI-TB) with that by standard systematic biopsy (SB) and to evaluate the role of MRI-TB as a replacement from SB in men at clinical risk of prostate cancer.

Methods

The non-systematic literature was searched for peer-reviewed English-language articles using PubMed, including the prospective paired studies, where the index test was MRI-TB and the comparator text was SB. Also the randomized clinical trials (RCTs) are included if one arm was MRI-TB and another arm was SB.

Results

Eighteen prospective studies used both MRI-TB and TRUS-SB, and eight RCT received one of the tests for prostate cancer detection. In most prospective trials to compare MRI-TB vs. SB, there was no significant difference in any cancer detection rate; however, MRI-TB detected more men with CSCa and fewer men with CISCa than SB.

Conclusion

MRI-TB is superior to SB in detection of CSCa. Since some significant cancer was detected by SB only, a combination of SB with the TB technique would avoid the underdiagnosis of CSCa.

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Abbreviations

COG-TB:

Cognitive fusion targeted biopsy

CSCa:

Clinically significant prostate cancer

CISCa:

Clinically insignificant prostate cancer

CDRs:

Cancer detection rates

GS:

Gleason score

PSA:

Prostatic-specific antigen

RCT:

Randomized controlled trial

SB:

Systematic biopsy

TB:

Targeted biopsy

TRUS:

Transrectal ultrasonography

MRI:

Magnetic resonance imaging

MRUS:

Magnetic resonance ultrasonography

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Authors and Affiliations

  1. Department of Urology, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kyoto, 602-8566, Japan

    Yasuhiro Yamada, Osamu Ukimura, Masatomo Kaneko, Toru Matsugasumi & Atsuko Fujihara

  2. Division of Urology, Rush University Medical Center, Chicago, IL, USA

    Srinivas Vourganti

  3. Department of Urology, University of California, Los Angeles, CA, USA

    Leonard Marks

  4. Urologic Oncology Branch, National Cancer Institute, Bethesda, MD, USA

    Abhinav Sidana

  5. Division of Urology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada

    Laurence Klotz

  6. Prostate Cancer Centre, Martini Clinic, University Medical Centre Eppendorf, Hamburg, Germany

    Georg Salomon

  7. Department of Urology, Istanbul Medipol University, Istanbul, Turkey

    Jean de la Rosette

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  1. Yasuhiro Yamada
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Correspondence to Osamu Ukimura.

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Yamada, Y., Ukimura, O., Kaneko, M. et al. Moving away from systematic biopsies: image-guided prostate biopsy (in-bore biopsy, cognitive fusion biopsy, MRUS fusion biopsy) —literature review. World J Urol 39, 677–686 (2021). https://doi.org/10.1007/s00345-020-03366-x

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