MRI-Guided Biopsy for Prostate Cancer Detection: A Systematic Review of Current Clinical Results
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In-bore magnetic resonance-guided biopsy (MRGB) has been increasingly used in clinical practice to detect prostate cancer (PCa). This review summarizes the current clinical results of this biopsy method. A systematic literature search was performed in the PubMed and Embase databases. Of 2,035 identified records, 49 required full review. In all, ten unique studies reporting clinical results of MRGB could be included. Reported PCa detection rates ranged from 8 to 59 % (median 42 %). The majority of tumors detected by MRGB were clinically significant (81–93 %). Most frequent complications of MRGB are transient hematuria (1–24 %) and short-term perirectal bleeding (11–17 %). Major complications are rare. Based on the reviewed literature, MRGB can be regarded an accurate and safe diagnostic tool to detect clinically significant PCa. However, as general availability is limited, this procedure should be reserved for specific patients. Appropriate indications will have to be determined.
KeywordsMRI Image-guided biopsy Prostate cancer Transient hematuria Short-term perirectal bleeding
Dr. Christiaan G. Overduin reported no conflicts of interest relevant to this article.
Dr. Jurgen J. Fütterer received consultancy from Invivo, Schwerin, Germany.
Dr. Jelle O. Barentsz reported no conflicts of interest relevant to this article.
Papers of particular interest, published recently, have been highlighted as: •• Of major importance
- 10.•• Pondman KM, Fütterer JJ, ten Haken B, et al. MR-guided biopsy of the prostate: an overview of techniques and a systematic review. Eur Urol. 2008;54(3):517–27. Extensive overview of current strategies to perform MRGB. The authors conclude that MRGB is a promising tool to use in patients with previous negative TRUSGB. PubMedCrossRefGoogle Scholar
- 15.Franiel T, Stephan C, Erbersdobler A, et al. Areas suspicious for prostate cancer: MR-guided biopsy in patients with at least one transrectal US-guided biopsy with a negative finding – multiparametric MR imaging for detection and biopsy planning. Radiology. 2011;259(1):162–72.PubMedCrossRefGoogle Scholar
- 16.Engehausen DG, Engelhard K, Schwab SA, et al. Magnetic resonance image-guided biopsies with a high detection rate of prostate cancer. Sci World J. 2012, Article ID 975971.Google Scholar
- 17.•• Hoeks CMA, Schouten MG, Bomers JGR, et al. Three-Tesla magnetic resonance-guided prostate biopsy in men with increased prostate-specific antigen and repeated, negative, random, systematic, transrectal ultrasound biopsies: detection of clinically significant prostate cancers. Eur Urol. 2012;62:902–9. Largest study describing clinical results of MRGB in patients with previous negative TRUSGB. In a cohort of 265 patients, the authors show MRGB to achieve high diagnostic performance at acceptable complication rates. PubMedCrossRefGoogle Scholar
- 19.Schwab SA, Kuefner MA, Adamietz B et al. MRI-guided core biopsy of the prostate in the supine position -- introduction of a simplified technique using large-bore magnet systems. Eur Radiol 2012, Epub ahead of print.Google Scholar
- 29.Hambrock T, Hoeks CM, Hulsbergen-van de Kaa C, et al. Prospective assessment of prostate cancer aggressiveness using 3-T diffusion-weighted magnetic resonance imaging–guided biopsies versus a systematic 10-core transrectal ultrasound prostate biopsy cohort. Eur Urol. 2012;61(1):177–84.PubMedCrossRefGoogle Scholar
- 39.•• Hadaschik BA, Kuru TH, Tulea C, et al. A novel stereotactic prostate biopsy system integrating pre-interventional magnetic resonance imaging and live ultrasound fusion. J Urol. 2011;186(6):2214–20. MR/TRUS-fusion guided biopsy may be a promising alternative to increase the general availability of targeted biopsy strategies. In their study, the authors report initial clinical experience using this technique in a transperineal approach, with promising results. PubMedCrossRefGoogle Scholar