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Micro-ultrasound-guided biopsies versus systematic biopsies in the detection of prostate cancer: a systematic review and meta-analysis

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A Letter to the Editor to this article was published on 26 September 2023

Abstract

Purpose

The diagnosis of prostate cancer (PCa) still relies on the performance of both targeted (TB) and systematic biopsies (SB). Micro-ultrasound (mUS)-guided biopsies demonstrated a high sensitivity in detecting clinically significant prostate cancer (csPCa), which could be comparable to that of magnetic resonance imaging (MRI)-TB, but their added value has not been compared to SB yet.

Methods

We conducted a systematic review and meta-analysis, based on Medline, EMBASE, Scopus, and Web of Science, in accordance with PRISMA guidelines, to compare mUS-guided biopsies to SB.

Results

Based on the literature search of 2957 articles, 15 met the inclusion criteria (2967 patients). Most patients underwent mUS-guided biopsies, followed by MRI-TB and SB. Respectively 5 (n = 670) and 4 (n = 467) studies, providing raw data on SB, were included in a random-effect meta-analysis of the detection rate of csPCa, i.e. Gleason Grade Group (GGG) ≥ 2 or non-csPCa (GGG = 1). Overall, PCa was detected in 56–71% of men, with 31.3–49% having csPCa and 17–25.4% having non-csPCa. Regarding csPCa, mUS-guided biopsies identified 196 and SB 169 cases (Detection Ratio (DR): 1.18, 95% CI 0.83–1.68, I2 = 69%), favoring mUS-guided biopsies; regarding non-csPCa, mUS-guided biopsies identified 62 and SB 115 cases (DR: 0.55, 95% CI 0.41–0.73, I2 = 0%), also favoring mUS-guided biopsies by decreasing unnecessary diagnosis.

Conclusion

Micro-ultrasound-guided biopsies compared favorably with SB for the detection of csPCa and detected fewer non-csPCa than SB. Prospective trials are awaited to confirm the interest of adding mUS-guided biopsies to MRI-TB to optimize csPCa detection without increasing overdiagnosis of non-csPCa.

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Data availability

Data can be made available upon reasonable request.

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Authors and Affiliations

  1. Department of Urology, Hôpital Européen Georges-Pompidou, APHP, Paris–Paris Cité University–U1151 Inserm-INEM, Necker, Paris, France

    Charles Dariane

  2. Department of Urology, La Croix du Sud Hôpital, Quint Fonsegrives, France

    Guillaume Ploussard & Jean-Baptiste Beauval

  3. Department of Urology, Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, France

    Guillaume Ploussard

  4. Department of Urology, Institut Mutualiste Montsouris, Paris, France

    Eric Barret

  5. Department of Urology, CHU de Pointe-À-Pitre, University of Antilles, University of Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail)-UMR_S 1085, 97110, Pointe-à-Pitre, France

    Laurent Brureau

  6. Department of Radiotherapy, Institut Curie, Paris, France

    Gilles Créhange

  7. Department of Pathology, CHRU Tours, Tours, France

    Gaëlle Fromont

  8. Department of Nuclear Medicine, Scintep–Institut Daniel Hollard, Grenoble, France

    Mathieu Gauthé

  9. Department of Urology, CHU Rennes, Rennes, France

    Romain Mathieu

  10. AP-HP, Radiology, Pitie-Salpetriere Hospital, Sorbonne University, 75013, Paris, France

    Raphaële Renard-Penna

  11. Department of Medical Oncology, Institut Bergonié, 33000, Bordeaux, France

    Guilhem Roubaud

  12. Service d’urologie Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France

    Alain Ruffion

  13. Equipe 2, Centre d’Innovation en Cancérologie de Lyon (EA 3738 CICLY), Faculté de médecine Lyon Sud, Université Lyon 1, Lyon, France

    Alain Ruffion

  14. Department of Radiotherapy, Institut Bergonié, 33000, Bordeaux, France

    Paul Sargos

  15. GRC 5 Predictive Onco-Uro, AP-HP, Urology, Pitie-Salpetriere Hospital, Sorbonne University, 75013, Paris, France

    Morgan Rouprêt

  16. Department of Urology, Grenoble Alpes University Hospital, Université Grenoble Alpes, CNRS, Grenoble INP, TIMC-IMAG, Grenoble, France

    Gaëlle Fiard

  17. IUCT-O, Toulouse, France

    Guillaume Ploussard & Jean-Baptiste Beauval

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  1. Charles Dariane
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  2. Guillaume Ploussard
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Consortia

the Prostate Cancer Committee of the Association Française d’Urologie (CC-AFU)

Contributions

CD contributed to project development, data collection, and manuscript writing. GP was involved in project development, data analysis, manuscript editing, and supervision. EB, AR, and PS performed manuscript editing and critical revision. JBB, LB, GC, GF, MG, RM, RR-P, and G Roubaud edited the manuscript. MR contributed to project development and manuscript editing. GF was involved in project development, data analysis, statistical analysis, and manuscript writing.

Corresponding author

Correspondence to Charles Dariane.

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Conflict of interest

The authors state that they have no conflicts of interest to disclose regarding the current manuscript.

Research involving human participants and/or animals

Based on systematic review with meta-analysis on published data, this research did not involve human participants and/or animals.

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This systematic review with meta-analysis on published data has provided consent retrieved within each study.

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Dariane, C., Ploussard, G., Barret, E. et al. Micro-ultrasound-guided biopsies versus systematic biopsies in the detection of prostate cancer: a systematic review and meta-analysis. World J Urol 41, 641–651 (2023). https://doi.org/10.1007/s00345-022-04087-z

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