Armando Stabile1,2,3, Francesco Giganti4,5, Mark Emberton6,4, Caroline M Moore6,4. 1. Department of Urology, University College London Hospitals NHS Foundation Trust, London, UK. armando.stabile88@gmail.com. 2. Division of Surgery & Interventional Science, University College London, London, UK. armando.stabile88@gmail.com. 3. Department of Urology and Division of Experimental Oncology, URI, Urological Research Institute, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute, Milan, Italy. armando.stabile88@gmail.com. 4. Division of Surgery & Interventional Science, University College London, London, UK. 5. Department of Radiology, University College London Hospitals NHS Foundation Trust, London, UK. 6. Department of Urology, University College London Hospitals NHS Foundation Trust, London, UK.
Abstract
INTRODUCTION: In recent years, evidence has accrued to support the introduction of multiparametric magnetic resonance imaging (mpMRI) in the prostate cancer diagnostic pathway. The exact role of mpMRI in different settings is not widely agreed. In this review, we look at the use of MRI in three groups of men: biopsy naive men, those with a previous negative biopsy and those with a previous positive biopsy suitable for active surveillance. MATERIAL AND METHODS: An electronic MEDLINE/PubMed search up to 24th January 2018 was performed, using the search terms (prostate cancer OR prostate adenocarcinoma) AND (MRI OR magnetic resonance) AND (biopsy naive OR active surveillance OR prior negative biopsy OR no prior biopsy). Only those studies which reported detection rates of standard biopsy and MRI-targeted biopsy, where all men had both an MRI and standard biopsy were included. RESULTS: In total 34 articles were included (14 biopsy naive, 10 prior negative biopsy, and 10 prior positive biopsy). MRI-targeted biopsy consistently resulted in greater detection of clinically significant prostate cancer, and a lower detection of clinically insignificant prostate cancer, across all three patient populations. This effect was most prominent in men with at least one previous negative biopsy, and least prominent in men on active surveillance. In the presence of a negative mpMRI detection of csPCa found at systematic biopsy ranged from 0 to 20%. CONCLUSIONS: MRI-targeted biopsy is more efficient than standard biopsy in detecting clinically significant disease in men with a positive MRI, and results in less detection of clinically insignificant cancer. In men with a negative MRI, a significant minority of men will have clinically significant cancer detected on systematic biopsy.
INTRODUCTION: In recent years, evidence has accrued to support the introduction of multiparametric magnetic resonance imaging (mpMRI) in the prostate cancer diagnostic pathway. The exact role of mpMRI in different settings is not widely agreed. In this review, we look at the use of MRI in three groups of men: biopsy naive men, those with a previous negative biopsy and those with a previous positive biopsy suitable for active surveillance. MATERIAL AND METHODS: An electronic MEDLINE/PubMed search up to 24th January 2018 was performed, using the search terms (prostate cancer OR prostate adenocarcinoma) AND (MRI OR magnetic resonance) AND (biopsy naive OR active surveillance OR prior negative biopsy OR no prior biopsy). Only those studies which reported detection rates of standard biopsy and MRI-targeted biopsy, where all men had both an MRI and standard biopsy were included. RESULTS: In total 34 articles were included (14 biopsy naive, 10 prior negative biopsy, and 10 prior positive biopsy). MRI-targeted biopsy consistently resulted in greater detection of clinically significant prostate cancer, and a lower detection of clinically insignificant prostate cancer, across all three patient populations. This effect was most prominent in men with at least one previous negative biopsy, and least prominent in men on active surveillance. In the presence of a negative mpMRI detection of csPCa found at systematic biopsy ranged from 0 to 20%. CONCLUSIONS: MRI-targeted biopsy is more efficient than standard biopsy in detecting clinically significant disease in men with a positive MRI, and results in less detection of clinically insignificant cancer. In men with a negative MRI, a significant minority of men will have clinically significant cancer detected on systematic biopsy.
Authors: Armando Stabile; Francesco Giganti; Andrew B Rosenkrantz; Samir S Taneja; Geert Villeirs; Inderbir S Gill; Clare Allen; Mark Emberton; Caroline M Moore; Veeru Kasivisvanathan Journal: Nat Rev Urol Date: 2019-07-17 Impact factor: 14.432
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Authors: Anwar R Padhani; Jelle Barentsz; Geert Villeirs; Andrew B Rosenkrantz; Daniel J Margolis; Baris Turkbey; Harriet C Thoeny; François Cornud; Masoom A Haider; Katarzyna J Macura; Clare M Tempany; Sadhna Verma; Jeffrey C Weinreb Journal: Radiology Date: 2019-06-11 Impact factor: 11.105
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