MP86-18 MRI TARGETED BIOPSY MAY ENHANCE DIAGNOSTIC PERFORMANCE OF SIGNIFICANT PROSTATE CANCER DETECTION COMPARED TO STANDARD TRANSRECTAL ULTRASOUND GUIDED BIOPSY: A SYSTEMATIC REVIEW AND META-ANALYSIS

Abstract

You have accessJournal of UrologyProstate Cancer: Detection and Screening VII1 Apr 2015MP86-18 MRI TARGETED BIOPSY MAY ENHANCE DIAGNOSTIC PERFORMANCE OF SIGNIFICANT PROSTATE CANCER DETECTION COMPARED TO STANDARD TRANSRECTAL ULTRASOUND GUIDED BIOPSY: A SYSTEMATIC REVIEW AND META-ANALYSIS Ivo Schoots, Monique Roobol, Arnout Alberts, Daan Nieboer, Chris Bangma, Ewout Steyerberg, and Myriam Hunink Ivo SchootsIvo Schoots More articles by this author , Monique RoobolMonique Roobol More articles by this author , Arnout AlbertsArnout Alberts More articles by this author , Daan NieboerDaan Nieboer More articles by this author , Chris BangmaChris Bangma More articles by this author , Ewout SteyerbergEwout Steyerberg More articles by this author , and Myriam HuninkMyriam Hunink More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1927AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES A major limitation of prostate cancer detection by transrectal ultrasound guided biopsy (TRUS-Bx) is undersampling of significant tumours and oversampling of potentially insignificant tumours. Prostate MRI may improve diagnostic performance of prostate cancer detection by enabling targeted biopsy (MRI-TBx). OBJECTIVE To systematically review and meta-analyse evidence regarding the diagnostic performance of MRI-TBx (index test) versus TRUS-Bx (current reference standard) in detection of overall prostate cancer, and significant and insignificant prostate cancer. METHODS A systematic review of the literature (i.e. Embase, Medline, PubMed) was performed according to the PRISMA statement. Identified reports were critically appraised according to the QUADAS criteria. Only studies applying a sequential sampling design of the two biopsy tests, MRI-TBx and TRUS-Bx, in the same man, were selected. MRI-TBx was performed by visual estimation, software-registered fusion between MRI and US, or ‘in-bore’ targeted biopsy. TRUS-Bx was performed by transrectal systematic 10-12 core biopsies. RESULTS Included reports (16) used both MRI-TBx and TRUS-Bx for prostate cancer detection. A cumulative total of 1926 men with positive MRI were included, with prostate cancer prevalence of 59%. - MRI-TBx and TRUS-Bx did not show significant differences in overall prostate cancer detection (sensitivity 0.85 [CI 0.80, 0.89] and 0.81 [0.70, 0.88], respectively). - MRI-TBx showed increased significant prostate cancer detection (sensitivity 0.91 [0.87, 0.94] and 0.76 [0.64, 0.84], respectively). - MRI-TBx showed decreased insignificant prostate cancer detection (sensitivity 0.44 [0.26, 0.64] and 0.83 [0.77, 0.87] respectively). - Subgroup analysis showed improvement of significant prostate cancer detection by MRI-TBx in men with previous negative biopsy, rather than in men with initial biopsy (relative sensitivity of 1.54 [1.05, 2.57] and 1.10 [1.00, 1.22]). CONCLUSIONS In men with a clinical suspicion of prostate cancer and a subsequent positive MRI, MRI targeted biopsy and TRUS guided biopsy did not differ in overall prostate cancer detection. However, MRI-TBx resulted in a higher detection rate of significant prostate cancer and a lower detection rate of insignificant prostate cancer, compared with TRUS-guided biopsy. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e1082 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ivo Schoots More articles by this author Monique Roobol More articles by this author Arnout Alberts More articles by this author Daan Nieboer More articles by this author Chris Bangma More articles by this author Ewout Steyerberg More articles by this author Myriam Hunink More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...