Comparison of Multiparametric Magnetic Resonance Imaging and Targeted Biopsy With Systematic Biopsy Alone for the Diagnosis of Prostate Cancer

Elwenspoek, Martha M. C.; Sheppard, Athena L.; McInnes, Matthew D. F.; Merriel, Samuel W D; Rowe, Edward; Bryant, Richard J.; Donovan, Jenny; Whiting, Paul J.

doi:10.1001/jamanetworkopen.2019.8427

Cited by 71 publications

(44 citation statements)

References 40 publications

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“…Many studies have shown that the utility of FBx is in the combination of SBx and MRI-targeted cores, [3][4][5][6][7][8] although some studies argue that MRI-targeted cores alone would significantly reduce insignificant cancer diagnosis. 9 In contrast to the multitude of studies on the possible efficacy of MRItargeted biopsy alone in FBx, to our knowledge, there has not been a study that looked solely at utilization of the machineguided SBx of an FBx captured by a software-assisted (fusion) registration device. We sought to compare the CS CDRs of machine-guided SBx with the standard, freehand TRUS-SBx in hopes of identifying a newfound usage for softwareassisted (fusion) registration devices in the detection of PCa.…”

Section: Discussionmentioning

confidence: 99%

A Comparison of Cancer Detection Rates Between Template Systematic Biopsies Obtained Using Magnetic Resonance Imaging-Ultrasound Fusion Machine and Freehand Transrectal Ultrasound-Guided Systematic Biopsies

Hoge

Maynor

Guan

et al. 2020

Journal of Endourology

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Introduction: There are reports that the 12-core template systematic biopsies (SBx) obtained by using software registration machines (e.g., Artemis) have higher cancer detection rates (CDRs) of prostate cancer (PCa) than the standard, freehand 12-core transrectal ultrasound (TRUS)-guided biopsies. The goal of our study is to compare the clinically significant (CS) CDRs of SBx in two independent cohorts who underwent freehand TRUS-SBx alone (Cohort A) or machine-guided SBx as part of a combined MRI-ultrasound (MRI-US) fusion biopsy (FBx) (Cohort B). Materials and Methods: A retrospective review of all patients undergoing prostate biopsies over a 4-year period at the University of Cincinnati Medical Center was performed. CS cancer was defined as having a Gleason score ‡7. MRI-US FBx were obtained by using an Artemis software registration device (ARTEMISÔ, Eigen, Inc., Grass Valley, CA). Statistical significance was considered at p < 0.05. Results: Nine hundred and thirty men underwent SBx (Cohort A: 474, Cohort B: 456). There were no statistical differences between cohort A and B in CS CDRs in the overall population (39.3% vs 33.8%; p = 0.093), biopsy naive patients (40.4% vs 39.8%; p = 0.951), or patients with a prior negative biopsy (22.7% vs 25.0%; p = 0.910). Multivariate logistic regression controlling for age, race, prostate-specific antigen level, prostate volume, abnormal digital rectal exam, and family history of PCa demonstrated comparable CS CDRs, which was maintained when further stratified by prior biopsy history (all patients: odds ratio [OR] 0.99, 95% confidence interval [CI] 0.71-1.38, p = 0.958; biopsy naive: OR 0.79, 95% CI 0.51-1.22, p = 0.291; prior negative biopsy: OR 0.64, 95% CI 0.21-1.75, p = 0.403). Conclusions: Our study did not find a significant difference in the CS CDRs of machine-guided SBx compared with the freehand TRUS-SBx. Unless the SBx is done at the time of FBx, the use of these machines for obtaining SBx only is unlikely to result in any increase of CS CDRs.

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Section: Discussionmentioning

confidence: 99%

A Comparison of Cancer Detection Rates Between Template Systematic Biopsies Obtained Using Magnetic Resonance Imaging-Ultrasound Fusion Machine and Freehand Transrectal Ultrasound-Guided Systematic Biopsies

Hoge

Maynor

Guan

et al. 2020

Journal of Endourology

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“… Elwenspoek et al. [ 35 ] - Systematic review and meta-analysis - Evaluated three biopsy Pathway systematic biopsy MRI-TB Both pathway - 7 RCTs (2 582 men) csPca definition varied in different series - 57% improvement in detection of csPca, 33% reduction in number of biopsy and 77% reduction in the number of cores. Woo et al [ 36 ] - Systematic reviews and meta-analysis MRI-TB MRI plus systematic biopsy as intervention Systemic TRUS as comparator - 9 RCTs (2 908 men) csPca definition varied in different series - MRI stratified pathway detected more clinically significant PCa than TRUS biopsy (relative detection rate 1.45 for all men, 1.42 for biopsy naïve and 1.6 for men with prior negative biopsy).…”

Section: Mri-tbmentioning

confidence: 99%

Magnetic resonance imaging-guided prostate biopsy—A review of literature

Bhat

Samavedi

Moschovas

et al. 2021

Asian Journal of Urology

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Objective Multiparametric magnetic resonance imaging (MP-MRI) helps to identify lesion of prostate with reasonable accuracy. We aim to describe the various uses of MP-MRI for prostate biopsy comparing different techniques of MP-MRI guided biopsy. Materials and methods A literature search was performed for “multiparametric MRI”, “MRI fusion biopsy”, “MRI guided biopsy”, “prostate biopsy”, “MRI cognitive biopsy”, “MRI fusion biopsy systems”, “prostate biopsy” and “cost analysis”. The search operation was performed using the operator “OR” and “AND” with the above key words. All relevant systematic reviews, original articles, case series, and case reports were selected for this review. Results The sensitivity of MRI targeted biopsy (MRI-TB) is between 91%–93%, and the specificity is between 36%–41% in various studies. It also has a high negative predictive value (NPV) of 89%–92% and a positive predictive value (PPV) of 51%–52%. The yield of MRI fusion biopsy (MRI-FB) is similar, if not superior to MR cognitive biopsy. In-bore MRI-TB had better detection rates compared to MR cognitive biopsy, but were similar to MR fusion biopsy. Conclusions The use of MRI guidance in prostate biopsy is inevitable, subject to availability, cost, and experience. Any one of the three modalities ( i.e. MRI cognitive, MRI fusion and MRI in-bore approach) can be used. MRI-FB has a fine balance with regards to accuracy, practicality and affordability.

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“…The article by Elwenspoek et al 7 summarizes the findings of 7 randomized clinical trials evaluating whether the traditional technique of obtaining 10 to 12 biopsy cores distributed within the prostate is superior to a technique that biopsies only lesions seen at MRI. The clinical trials differed in many respects, but the overarching conclusion is that targeted biopsies appear to be much better at identifying clinically significant disease while avoiding clinically insignificant disease than techniques that sample the entire prostate.…”

Section: Scandinavian Prostate Cancer Group 4 Trial and The Goteborgmentioning

confidence: 99%

The Evolving Paradigm of Prostate Cancer Screening

Albertsen

2019

JAMA Netw Open

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The 1987 report by Stamey et al 1 showing that prostate-specific antigen (PSA) levels correlate with prostate cancer volume ushered in the modern age of prostate cancer management. Four years later, Catalona et al 2 published results from a large case series analysis showing that men undergoing biopsy as the result of an elevated serum PSA level frequently harbor prostate cancer. Shortly thereafter, screening for prostate cancer with serum PSA level became the standard of care in North America, and the incidence of prostate cancer tripled. 3 Equally important, clinicians during this era considered all cancers identified by PSA testing to be clinically significant; as a consequence, most of the men who received a diagnosis of prostate cancer underwent treatment with surgery or radiation. Unfortunately, many of these men experienced incontinence, impotence, or bowel dysfunction as a result. Many European countries, especially the United Kingdom, were much more hesitant to adopt PSA screening. Urologists in Scandinavian countries recognized that men with well-differentiated prostate cancer often lived many years with their disease without symptoms. They organized the

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Comparison of Multiparametric Magnetic Resonance Imaging and Targeted Biopsy With Systematic Biopsy Alone for the Diagnosis of Prostate Cancer

Cited by 71 publications

References 40 publications

A Comparison of Cancer Detection Rates Between Template Systematic Biopsies Obtained Using Magnetic Resonance Imaging-Ultrasound Fusion Machine and Freehand Transrectal Ultrasound-Guided Systematic Biopsies

A Comparison of Cancer Detection Rates Between Template Systematic Biopsies Obtained Using Magnetic Resonance Imaging-Ultrasound Fusion Machine and Freehand Transrectal Ultrasound-Guided Systematic Biopsies

Magnetic resonance imaging-guided prostate biopsy—A review of literature

The Evolving Paradigm of Prostate Cancer Screening

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