Robot-Assisted Magnetic Resonance Imaging-Targeted versus Systematic Prostate Biopsy; Systematic Review and Meta-Analysis

Petov, Vladislav; Azilgareeva, Camilla; Shpikina, Anastasia; Morozov, Andrey; Крупинов, Г Е; Козлов, В. В.; Singla, Nirmish; Rivas, Juan Gómez; Sierra, Jesús Moreno; Puliatti, Stefano; Checcucci, Enrico; Rodler, Severin; Belenchón, I. Rivero; Kowalewski, Karl‐Friedrich; Veccia, Alessandro; McFarland, Jonathan; Cacciamani, Giovanni; Taratkin, Mark; Enikeev, Dmitry

doi:10.3390/cancers15041181

Cited by 7 publications

(5 citation statements)

References 52 publications

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“…Petov et al have recently published a meta-analysis which concluded that robotic biopsy on targeted and systematic biopsy have comparable csPCa and overall detection rates [ 58 ]. In line with the results of these studies, the Cochrane systematic review makes clear its position regarding the complementarity of systematic biopsies with targeted biopsies via the transrectal route [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

A Systematic Review of the Current Status of Magnetic Resonance–Ultrasound Images Fusion Software Platforms for Transperineal Prostate Biopsies

Paesano,

Catalá,

Tcholakian

et al. 2023

Cancers

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Given this new context, our objective is to recognize the suitability of the currently available software for image fusion and the reported series using the transperineal route, as well as to generate new evidence on the complementarity of the directed and systematic biopsies, which has been established through the transrectal approach. Evidence acquisition: This systematic review, registered in Prospero (CRD42022375619), began with a bibliographic search that was carried out in PubMed, Cochrane, and Google Scholar databases. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) criteria and the studied eligibility based on the Participants, Intervention, Comparator, and Outcomes (PICO) strategy were followed. Warp analysis of selected studies was performed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. In addition, a Google search of all currently available fusion platforms was performed. Our Google search found 11 different commercially available robots to perform transperineal image fusion biopsies, of which 10 devices have published articles supporting their diagnostic effectiveness in transperineal prostate biopsies. Results: A total of 30 articles were selected and the characteristics and results of the biopsies of 11,313 patients were analyzed. The pooled mean age was 66.5 years (63–69). The mean pooled PSA level was 7.8 ng/mL (5.7–10.8). The mean pooled prostate volume was 45.4 cc. (34–56). The mean pooled PSA density was 0.17 (0.12–0.27). The overall cancer detection rate for all prostate cancers was 61.4%, while for csPCa it was 47.8%. PCa detection rate was more effective than that demonstrated in the systematic transrectal biopsy. However, the detection of csPCa in the systematic biopsy was only 9.5% in the reported series. To standardize our review, we grouped prostate cancer screening results according to the population studied and the software used. When the same populations were compared between elastic and rigid software, we found that rigid biopsies had a higher csPCa detection rate than biopsies with elastic fusion systems. Conclusion: Platforms performing prostate biopsy using transperineal image fusion have better detection rates of csPCa than systematic transrectal biopsies. Rigid fusion systems have a better csPCa detection rate than elastic ones. We found no diagnostic differences between the different types of robotic systems currently available. The complementarity of systematic biopsy has also been demonstrated in transperineal imaging fusion biopsies.

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Section: Discussionmentioning

confidence: 99%

A Systematic Review of the Current Status of Magnetic Resonance–Ultrasound Images Fusion Software Platforms for Transperineal Prostate Biopsies

Paesano,

Catalá,

Tcholakian

et al. 2023

Cancers

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“…The only study where saFB was superior to cFB is the one by Patel et al [ 20 ], in which the software-assisted fusion was performed with an elastic semi-automatic robot-assisted technique (UroBiopsyTM; Biobot Surgical). Their results may be in line with the inherent features of the robotic system, which allows for the reduction in prostate displacement and deformation during the biopsy, thus minimizing the mismatches of the fusion-guided process leading to more precise punctures and representing a promising tool to develop in the near future [ 39 ].…”

Section: Discussionmentioning

confidence: 86%

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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“…Regarding the complementarity of systematic biopsies for detecting csPCa, Petov et al ( 40 ) have published a meta-analysis concluding that targeted and systematic biopsies have comparable csPCa detection rates. Marra et al ( 41 ) reported that the PCa detection rate of targeted biopsy was higher than that of systematic biopsies, but their role should not be overlooked, and the combination of targeted and systematic biopsies is essential.…”

Section: Discussionmentioning

confidence: 99%

The effectiveness of mapping-targeted biopsies on the index lesion in transperineal prostate biopsies

Paesano,

Catalá,

Tcholakian

et al. 2024

Int. braz j urol.

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Purpose: To evaluate the eff ectiveness of mapping-targeted biopsies (MTB) on the index lesion for the detection of clinically significant prostate cancer (csPCa) in transperineal fusion-image prostate biopsies. Materials and Methods:A retrospective analysis was conducted on 309 men with suspected PCa who underwent prostate biopsies at the Creu Blanca reference center in Barcelona, Spain. The Prostate Imaging-Reporting and Data System (PI-RADS v.2.1) of the magnetic resonance images (MRI) were reclassified by an expert radiologist reading of pre-biopsy biparametric MRI used for segmentation of suspected lesions. Transperineal MTB of suspicious lesions and 12-core systematic biopsies were performed using the Artemis™ platform.CsPCa was defined as International Society of Urological Pathology grade group ≥ 2.Results: CsPCa was detected in 192 men (62.1%), with detection rates of 6.3% for PI-RADS 2, 26.8% for PI-RADS 3, 87.3% for PI-RADS 4, and 93.1% for PI-RADS 5. MTB of the index lesion identified 185 csPCa (96.3%). CsPCa was detected solely in systematic biopsies in three cases (1.6%), while an additional four cases (2.1%) were identified only in the second suspected lesion. A predictive model for csPCa detection in MTB of the index lesion was developed, with an AUC of 0.918 (95% CI 0.887-0.950). Conclusions:This model had the potential to avoid 23.3% of prostate biopsies without missing additional csPCa cases. MTB of the index lesion was highly eff ective for identifying csPCa in fusion transperineal prostate biopsies. A developed predictive model successfully reduced the need for almost one quarter of biopsies without missing csPCa cases.

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Robot-Assisted Magnetic Resonance Imaging-Targeted versus Systematic Prostate Biopsy; Systematic Review and Meta-Analysis

Cited by 7 publications

References 52 publications

A Systematic Review of the Current Status of Magnetic Resonance–Ultrasound Images Fusion Software Platforms for Transperineal Prostate Biopsies

A Systematic Review of the Current Status of Magnetic Resonance–Ultrasound Images Fusion Software Platforms for Transperineal Prostate Biopsies

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

The effectiveness of mapping-targeted biopsies on the index lesion in transperineal prostate biopsies

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