Evaluation of MR imaging-targeted biopsies of the prostate in biopsy-naïve patients. A single centre study

Bennett, J. Garcia; Vilanova, Joan C.; Padró, Josep Gumà; Parada, David; Conejero, A.

doi:10.1016/j.diii.2017.06.010

Cited by 17 publications

(8 citation statements)

References 32 publications

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“…Many groups reported mpMRI had excellent negative predictive value for ruling out csPCa [10] . Yet, analysis of several prospective monocenter trials showed that combined systematic and targeted biopsy performed substantially better than targeted biopsy alone [52] , [56] , [57] , [58] , [59] , which is in line with the MRI-FIRST results. Interestingly, one retrospective study of 211 patients with unilateral MRI lesions reported that systematic biopsy was useful in addition to targeted biopsy in the lobe containing the MRI lesion; in contrast, the added value of the systematic biopsy of the contralateral lobe was marginal [60] .…”

Section: The Role Of Mpmri In the Management Of Clinically Localized supporting

confidence: 70%

“…In biopsy-naïve patients, several prospective monocenter trials gave conflicting results on the added value of targeted biopsy as compared to standard systematic biopsy [48] , [49] , [50] , [51] , [52] . However, three recent large prospective multicenter studies gave concordant results that may change guidelines on this matter.…”

Section: The Role Of Mpmri In the Management Of Clinically Localized mentioning

confidence: 99%

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The current role of prostate multiparametric magnetic resonance imaging

Rouvière

Moldovan

2019

Asian Journal of Urology

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Prostate multi-parametric magnetic resonance imaging (mpMRI) has shown excellent sensitivity for Gleason ≥7 cancers, especially when their volume is ≥0.5 mL. As a result, performing an mpMRI before prostate biopsy could improve the detection of clinically significant prostate cancer (csPCa) by adding targeted biopsies to systematic biopsies. Currently, there is a consensus that targeted biopsies improve the detection of csPCa in the repeat biopsy setting and at confirmatory biopsy in patients considering active surveillance. Several prospective multicentric controlled trials recently showed that targeted biopsy also improved csPCa detection in biopsy-naïve patients. The role of mpMRI and targeted biopsy during the follow-up of active surveillance remains unclear. Whether systematic biopsy could be omitted in case of negative mpMRI is also a matter of controversy. mpMRI did show excellent negative predictive values (NPV) in the literature, however, since NPV depends on the prevalence of the disease, negative mpMRI findings should be interpreted in the light of a priori risk for csPCa of the patient. Nomograms combining mpMRI findings and classical risk predictors (age, prostate-specific antigen density, digital rectal examination, etc. ) will probably be developed in the future to decide whether a prostate biopsy should be obtained. mpMRI has a good specificity for detecting T3 stage cancers, but its sensitivity is low. It should therefore not be used routinely for staging purposes in low-risk patients. Nomograms combining mpMRI findings and other clinical and biochemical data will also probably be used in the future to better assess the risk of T3 stage disease.

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Section: The Role Of Mpmri In the Management Of Clinically Localized supporting

confidence: 70%

Section: The Role Of Mpmri In the Management Of Clinically Localized mentioning

confidence: 99%

The current role of prostate multiparametric magnetic resonance imaging

Rouvière

Moldovan

2019

Asian Journal of Urology

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“…We found 39 retrospective studies, 46 prospective studies, and 13 RCTs where periprocedural antibiotics were administered [12] , [13] , [14] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] , [59] , [60] , [61] , [62] , [63] , [64] , [65] , [67] , [68] , [70] , [71] , [72] , [73] , [74] , [75] , [76] , [77] , [78] , [79] , [80] , [81] , [82] , [83] , [84] , [85] , …”

Section: Evidence Synthesisunclassified

Role of Prophylactic Antibiotics in Transperineal Prostate Biopsy: A Systematic Review and Meta-analysis

Basourakos

Alshak

Lewicki

et al. 2022

European Urology Open Science

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“…Local anaesthetic transperineal procedures were relatively well tolerated, with a low rate of procedural abandonment (26/ 6954, 0.37%; Table 2). Of the 14 studies that assessed pain during different stages of the biopsy, LA infiltration was rated as the most uncomfortable stage in 13 studies, while ultrasonography probe insertion was rated most uncomfortable in one study by Thurtle et al [7,8,14,23,25,26,29,30,32,34,38,39,41,42].…”

Section: Tolerabilitymentioning

confidence: 99%

“…For example, the high rate of positive biopsies in some studies using the PPTAS device is likely to have been influenced by patient selection, as only patients with mpMRI Prostate Imaging-Reporting and Data System (PI-RADS) scores 3-5 and Likert scores 3-5 were included [25,36]. Additionally, clinically significant cancer was defined as Gleason ≥3 + 4 in all studies, however, Bass et al and Garcia Bennet et al also included cancer core length ≥4 mm as clinically significant cancer [6,23]. This variation in the definition of clinically significant cancer is a further example of the disparity in prostate biopsy and reflects the heterogeneity of the included studies.…”

Section: Cancer Detectionmentioning

confidence: 99%

A systematic review on the outcomes of local anaesthetic transperineal prostate biopsy

et al. 2022

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Objective To conduct a systematic review of the literature to assess the diagnostic ability, complication rate, patient tolerability, and cost of local anaesthetic (LA) transperineal prostate biopsy. Methods Two reviewers searched Medline, the Cochrane Library, and Embase for publications on LA transperineal prostate biopsy up to March 2021. Outcomes of interest included cancer detection rates, complication rates, pain assessments and cost. Results A total of 35 publications with 113 944 men were included in this review. The cancer detection rate for LA transperineal prostate biopsy in patients undergoing primary biopsy was 52% (95% confidence interval [CI] 0.45–0.60; I2 = 97) and the clinically significant cancer detection rate (Gleason≥3 + 4) was 37% (95% CI 0.24–0.52; I2 = 99%). The rate of infection‐related complications in the included studies was 0.15% (95% CI 0.0000–0.0043; I2 = 86). The LA transperineal procedures had a low rate of procedural abandonment (26/6954, 0.37%), with the greatest pain scores measured during LA administration. No formal cost analyses on LA transperineal prostate biopsies were identified in the literature. The overall risk of bias in the included studies was high, with considerable study heterogeneity and publication bias. Conclusion Transperineal prostate biopsy performed under LA is a viable option for centres interested in avoiding the risk of infection associated with transrectal biopsy, and the logistical burden of general anaesthesia. Further investigation into LA transperineal prostate biopsy with comparative studies is warranted for its consideration as the standard in prostate biopsy technique.

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Evaluation of MR imaging-targeted biopsies of the prostate in biopsy-naïve patients. A single centre study

Abstract: Detection rate of prostate cancer did not show significant differences between a TB and a SB technique in biopsy-naïve patients. However, targeted prostate biopsies demonstrated a better sampling effectiveness thus reducing the cores needed to diagnose clinically significant tumors.

Cited by 17 publications

References 32 publications

The current role of prostate multiparametric magnetic resonance imaging

The current role of prostate multiparametric magnetic resonance imaging

Role of Prophylactic Antibiotics in Transperineal Prostate Biopsy: A Systematic Review and Meta-analysis

A systematic review on the outcomes of local anaesthetic transperineal prostate biopsy

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