Impact of Direct MRI-Guided Biopsy of the Prostate on Clinical Management

Meermeier, Nicholas P.; Foster, Bryan R.; Liu, Jen Jane; Amling, Christopher L.; Coakley, Fergus V.

doi:10.2214/ajr.18.21009

Cited by 9 publications

(7 citation statements)

References 23 publications

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“…targeted biopsy and final surgical pathology (n = 20) [16], and the third describing the oncologic management impact of in-bore biopsy (n = 127) [17]. All patients in this study were included in a previous abstract comparing in-bore biopsy and fusion biopsy [18].…”

Section: Accepted Manuscriptmentioning

confidence: 99%

In-Bore Versus Fusion MRI–Targeted Biopsy of PI-RADS Category 4 and 5 Lesions: A Retrospective Comparative Analysis Using Propensity Score Weighting

Prince

Foster

Kaempf

et al. 2021

American Journal of Roentgenology

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Section: Accepted Manuscriptmentioning

confidence: 99%

In-Bore Versus Fusion MRI–Targeted Biopsy of PI-RADS Category 4 and 5 Lesions: A Retrospective Comparative Analysis Using Propensity Score Weighting

Prince

Foster

Kaempf

et al. 2021

American Journal of Roentgenology

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“…The use of multiparametric magnetic resonance imaging has allowed for higher accuracy of detecting clinically meaningful cancer, better patient selection, and radiation dose escalation. 27 , 29 - 31 Staging investigations evolved from the use of conventional imaging to the use of prostate-specific membrane antigen (PSMA)–based positron emission tomography (PET) scans. 32 Similar evolution has taken place in post-treatment response assessment.…”

Section: Discussionmentioning

confidence: 99%

Biochemical Recurrence Surrogacy for Clinical Outcomes After Radiotherapy for Adenocarcinoma of the Prostate

Roy,

Romero,

Michalski

et al. 2023

JCO

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PURPOSE The surrogacy of biochemical recurrence (BCR) for overall survival (OS) in localized prostate cancer remains controversial. Herein, we evaluate the surrogacy of BCR using different surrogacy analytic methods. MATERIALS AND METHODS Individual patient data from 11 trials evaluating radiotherapy dose escalation, androgen deprivation therapy (ADT) use, and ADT prolongation were obtained. Surrogate candidacy was assessed using the Prentice criteria (including landmark analyses) and the two-stage meta-analytic approach (estimating Kendall's tau and the R2). Biochemical recurrence-free survival (BCRFS, time from random assignment to BCR or any death) and time to BCR (TTBCR, time from random assignment to BCR or cancer-specific deaths censoring for noncancer-related deaths) were assessed. RESULTS Overall, 10,741 patients were included. Dose escalation, addition of short-term ADT, and prolongation of ADT duration significantly improved BCR (hazard ratio [HR], 0.71 [95% CI, 0.63 to 0.79]; HR, 0.53 [95% CI, 0.48 to 0.59]; and HR, 0.54 [95% CI, 0.48 to 0.61], respectively). Adding short-term ADT (HR, 0.91 [95% CI, 0.84 to 0.99]) and prolonging ADT (HR, 0.86 [95% CI, 0.78 to 0.94]) significantly improved OS, whereas dose escalation did not (HR, 0.98 [95% CI, 0.87 to 1.11]). BCR at 48 months was associated with inferior OS in all three groups (HR, 2.46 [95% CI, 2.08 to 2.92]; HR, 1.51 [95% CI, 1.35 to 1.70]; and HR, 2.31 [95% CI, 2.04 to 2.61], respectively). However, after adjusting for BCR at 48 months, there was no significant treatment effect on OS (HR, 1.10 [95% CI, 0.96 to 1.27]; HR, 0.96 [95% CI, 0.87 to 1.06] and 1.00 [95% CI, 0.90 to 1.12], respectively). The patient-level correlation (Kendall's tau) for BCRFS and OS ranged between 0.59 and 0.69, and that for TTBCR and OS ranged between 0.23 and 0.41. The R2 values for trial-level correlation of the treatment effect on BCRFS and TTBCR with that on OS were 0.563 and 0.160, respectively. CONCLUSION BCRFS and TTBCR are prognostic but failed to satisfy all surrogacy criteria. Strength of correlation was greater when noncancer-related deaths were considered events.

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“…In patients with a prior negative systematic biopsy, MRI will show a suspicious target in 36% to 90% of patients, and a biopsy directed to the target will be positive in 37% to 66% of patients, 31-33 with GG2+ cancer in 21% to 60% of patients. 31-33 Given the substantial rates of suspicious target identification and positive predictive value (PPV) for GG2+ disease in the repeat biopsy setting, an mpMRI is recommended if there was no prior MRI. 31. In patients with indications for a repeat biopsy who do not have a suspicious lesion on MRI, clinicians may proceed with a systematic biopsy.…”

Section: Guideline Statementsmentioning

confidence: 99%

“…The timing of additional testing should be based on reassessment of risk and SDM. 30 In patients with a prior negative systematic biopsy, MRI will show a suspicious target in 36% to 90% of patients, and a biopsy directed to the target will be positive in 37% to 66% of patients, [31][32][33] with GG2D cancer in 21% to 60% of patients. [31][32][33] Given the substantial rates of suspicious target identification and positive predictive value (PPV) for GG2D disease in the repeat biopsy setting, an mpMRI is recommended if there was no prior MRI.…”

Section: In Patients With Multifocal Hgpin Cliniciansmentioning

confidence: 99%

Early Detection of Prostate Cancer: AUA/SUO Guideline Part II: Considerations for a Prostate Biopsy

et al. 2023

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Purpose:The summary presented herein covers recommendations on the early detection of prostate cancer and provides a framework to facilitate clinical decision-making in the implementation of prostate cancer screening, biopsy, and follow-up. This is Part II of a two-part series focusing on initial and repeat biopsies, and biopsy technique. Please refer to Part I for discussion of initial prostate cancer screening recommendations.Materials and Methods:The systematic review utilized to inform this guideline was conducted by an independent methodological consultant. The systematic review was based on searches in Ovid MEDLINE and Embase and Cochrane Database of Systematic Reviews (January 1, 2000–November 21, 2022). Searches were supplemented by reviewing reference lists of relevant articles.Results:The Early Detection of Prostate Cancer Panel developed evidence- and consensus-based guideline statements to provide guidance in prostate cancer screening, initial and repeat biopsies, and biopsy technique.Conclusions:The evaluation of prostate cancer risk should be focused on the detection of clinically significant prostate cancer (Grade Group 2 or higher [GG2+]). The use of laboratory biomarkers, prostate MRI, and biopsy techniques described herein may improve detection and safety when a prostate biopsy is deemed necessary following prostate cancer screening.

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Impact of Direct MRI-Guided Biopsy of the Prostate on Clinical Management

Cited by 9 publications

References 23 publications

In-Bore Versus Fusion MRI–Targeted Biopsy of PI-RADS Category 4 and 5 Lesions: A Retrospective Comparative Analysis Using Propensity Score Weighting

In-Bore Versus Fusion MRI–Targeted Biopsy of PI-RADS Category 4 and 5 Lesions: A Retrospective Comparative Analysis Using Propensity Score Weighting

Biochemical Recurrence Surrogacy for Clinical Outcomes After Radiotherapy for Adenocarcinoma of the Prostate

Early Detection of Prostate Cancer: AUA/SUO Guideline Part II: Considerations for a Prostate Biopsy

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