Natural History of Patients with Prostate MRI Likert 1-3 and Development of RosCaP: a Multivariate Risk Score for Clinically Significant Cancer

Orecchia, Luca; Nardi, Alessandra; Fletcher, Peter; Ippoliti, Simona; Grounds, Jonathan; Dokubo, Ibifuro; Spicchiale, Claudia Fede; Miah, Saiful; Miano, Roberto; Barrett, Tristan; Kastner, Christof

doi:10.1016/j.clgc.2022.07.011

Cited by 3 publications

(1 citation statement)

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“…With the publication of data from the PROMIS trial [ 24 ], mpMRI imaging of the prostate has gained a pivotal role in the diagnostic pathway of PCa, and also in biopsy-naïve patients. Indeed, it has been demonstrated that mpMRI has high sensitivity for csPCa (93%) and high negative predictive value (90–91%), thus allowing a negligible amount of significant cancers to be missed during diagnostic assessment while limiting the detection of clinically insignificant ones [ 25 , 26 ]. Nowadays mpMRI interpretation following the PIRADS criteria [ 6 ] represents a sort of “triage” test, leading clinicians to postpone PB in the case of negative findings and to perform an FB in the case of the detection of suspicious lesions.…”

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confidence: 99%

Transperineal US-MRI Fusion-Guided Biopsy for the Detection of Clinical Significant Prostate Cancer: A Systematic Review and Meta-Analysis Comparing Cognitive and Software-Assisted Technique

Pirola

Castellani

Orecchia

et al. 2023

Cancers

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Introduction: We aimed to find potential differences in clinically significant prostate cancer (csPCa) detection rates between transperineal software-assisted fusion biopsy (saFB) and cognitive fusion biopsies (cFB). Methods: A systematic review of the literature was performed to identify comparative studies using PubMed, EMBASE, and Scopus according to the PICOS criteria. Cancer detection and complication rates were pooled using the Cochran–Mantel–Haenszel method with the random effect model and reported as odds ratios (ORs), 95% confidence intervals (CI), and p-values. A meta-analysis was performed using Review Manager (RevMan) 5.4 software by Cochrane Collaboration. The quality assessment of the included studies was performed using the Cochrane Risk of Bias tool, using RoB 2 for randomized studies and ROBINS-I for retrospective and nonrandomized ones. Results: Eight studies were included for the meta-analysis, including 1149 cases in software-based and 963 cases in cognitive fusion biopsy. The detection rates of csPCa were similar between the two groups (OR 1.01, 95% CI 0.74–1.37, p = 0.95). Study heterogeneity was low (I2 55%). Conclusion: There is no actual evidence of the superiority of saFB over cFB in terms of the csPCa detection rate. Operator experience and software availability can drive the choice of one fusion technique over the other.

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