Magnetic Resonance Imaging-targeted Biopsy Versus Systematic Biopsy in the Detection of Prostate Cancer: A Systematic Review and Meta-analysis
| Autor: | Yaalini Shanmugabavan, Debashis Sarkar, Yiannis Philippou, Veeru Kasivisvanathan, Armando Stabile, David Thurtle, Mark Emberton, Joana B. Neves, Yemisi Takwoingi, Caroline M. Moore, Massimo Valerio, Francesco Giganti, Keiran D. Clement, Jonathan J Deeks |
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| Rok vydání: | 2019 |
| Předmět: |
Image-Guided Biopsy
Male medicine.medical_specialty Prostate biopsy Biopsy Urology 030232 urology & nephrology Context (language use) Cochrane Library 03 medical and health sciences Prostate cancer 0302 clinical medicine medicine Humans medicine.diagnostic_test business.industry Prostate Prostatic Neoplasms Cancer Magnetic resonance imaging medicine.disease Magnetic Resonance Imaging Confidence interval 030220 oncology & carcinogenesis Meta-analysis Radiology business |
| Zdroj: | European Urology. 76:284-303 |
| ISSN: | 0302-2838 |
| Popis: | Magnetic resonance imaging (MRI)-targeted prostate biopsy (MRI-TB) may be an alternative to systematic biopsy for diagnosing prostate cancer.The primary aims of this systematic review and meta-analysis were to compare the detection rates of clinically significant and clinically insignificant cancer by MRI-TB with those by systematic biopsy in men undergoing prostate biopsy to identify prostate cancer.A literature search was conducted using the PubMed, Embase, Web of Science, Cochrane library, and Clinicaltrials.gov databases. We included prospective and retrospective paired studies where the index test was MRI-TB and the comparator test was systematic biopsy. We also included randomised controlled trials (RCTs) if one arm included MRI-TB and another arm included systematic biopsy. The risk of bias was assessed using a modified Quality Assessment of Diagnostic Accuracy Studies-2 checklist. In addition, the Cochrane risk of bias 2.0 tool was used for RCTs.We included 68 studies with a paired design and eight RCTs, comprising a total of 14709 men who either received both MRI-TB and systematic biopsy, or were randomised to receive one of the tests. MRI-TB detected more men with clinically significant cancer than systematic biopsy (detection ratio [DR] 1.16 [95% confidence interval {CI} 1.09-1.24], p0.0001) and fewer men with clinically insignificant cancer than systematic biopsy (DR 0.66 [95% CI 0.57-0.76], p0.0001). The proportion of cores positive for cancer was greater for MRI-TB than for systematic biopsy (relative risk 3.17 [95% CI 2.82-3.56], p0.0001).MRI-TB is an attractive alternative diagnostic strategy to systematic biopsy.We evaluated the published literature, comparing two methods of diagnosing prostate cancer. We found that biopsies targeted to suspicious areas on magnetic resonance imaging were better at detecting prostate cancer that needs to be treated and avoiding the diagnosis of disease that does not need treatment than the traditional systematic biopsy. |
| Databáze: | OpenAIRE |
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