Magnetic Resonance Imaging-targeted Prostate Biopsy Compared with Systematic Prostate Biopsy in Biopsy-naïve Patients with Suspected Prostate Cancer.

Autor:	Alkema NG; Department of Urology, Isala Hospital, Zwolle, The Netherlands., Hoogeveen SFJS; Department of Urology, Isala Hospital, Zwolle, The Netherlands., Cauberg ECC; Department of Urology, Isala Hospital, Zwolle, The Netherlands., Witte LPW; Department of Urology, Isala Hospital, Zwolle, The Netherlands., van 't Veer-Ten Kate M; Department of Radiology, Isala Hospital, Zwolle, The Netherlands., de Boer E; Department of Radiology, Isala Hospital, Zwolle, The Netherlands., Hoogland MAM; Department of Pathology, Isala Hospital, Zwolle, The Netherlands., Blanker MH; Department of General Practice and Elderly Care Medicine at the University Medical Center Groningen, University of Groningen, Groningen, The Netherlands., Boomsma MF; Department of Radiology, Isala Hospital, Zwolle, The Netherlands., Steffens MG; Department of Urology, Isala Hospital, Zwolle, The Netherlands.
Jazyk:	angličtina
Zdroj:	European urology open science [Eur Urol Open Sci] 2022 Sep 02; Vol. 44, pp. 125-130. Date of Electronic Publication: 2022 Sep 02 (Print Publication: 2022).
DOI:	10.1016/j.euros.2022.08.005
Abstrakt:	Background: It remains uncertain whether transrectal ultrasound (TRUS)-guided systematic biopsies can be omitted and rely solely on multiparametric magnetic resonance imaging-targeted biopsies (MRI-TBx) in biopsy-naïve men suspected of prostate cancer (PCa). Objective: To compare PCa detection in biopsy-naïve men between systematic biopsy and MRI-TBx. Design Setting and Participants: A prospective cohort study was conducted in a Dutch teaching hospital. Consecutive patients with suspected PCa, no history of biopsy, and no clinical suspicion of metastasis underwent both TRUS-guided systematic biopsies and MRI-TBx by multiparametric magnetic resonance imaging (mpMRI)-ultrasound fusion, including sham biopsies in case of negative mpMRI. Outcome Measurements and Statistical Analysis: Clinically significant PCa (csPCa), defined as group ≥2 on the International Society of Urological Pathology grading, was detected. Results and Limitations: The overall prevalence of csPCa, irrespective of biopsy technique, was 37.4% (132/353) in our population. MRI-TBx were performed in 263/353 (74.5%) patients with suspicious mpMRI (Prostate Imaging Reporting and Data System [PI-RADS] ≥3). The detection rates for csPCa were 39.5% for MRI-TBx and 42.9% for systematic biopsies. The added values, defined as the additional percentages of patients with csPCa detected by adding one biopsy technique, were 8.7% for the systematic biopsies and 5.3% for MRI-TBx. In patients with nonsuspicious mpMRI, five cases (6%) of csPCa were found by systematic biopsies. Conclusions: This study in biopsy-naïve patients suspected for PCa showed that systematic biopsies have added value to MRI-TBx alone in patients with mpMRI PI-RADS >2. Patient Summary: We studied magnetic resonance imaging (MRI)-guided prostate biopsy for diagnosing prostate cancer and compared it with the standard method of prostate biopsy. Standard systematic biopsies cannot be omitted in patients with suspicious MRI, as they add to the detection of significant prostate cancer. (© 2022 The Authors.)
Databáze:	MEDLINE
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