The Role of Multi-Parametric MRI and Fusion Biopsy for the Diagnosis of Prostate Cancer - A Systematic Review of Current Literature.

Introduction The use of mutiparametric MRI (MpMRI) guided fusion biopsy is becoming an increasingly popular investigation in an aid to increase diagnostic yield in those suspected of having prostate cancer (PCa). Before adopting this technology, it is necessary to confirm the accuracy, so that PCa can be reliably diagnosed with characterisation. Materials and Methods This chapter analysed the evidences, which varied from well-designed randomised controlled trials to case series to detect the accuracy of MpMRI compared with biopsy/ histology. Results MpMRI incorporating T2 and diffusion weighted imaging only detects tumours in around 92% cases. When dynamic contrast enhancement is added, cancer diagnosis is significantly improved. Fusion biopsy increases the detection of high-risk PCa by 32% over conventional biopsy alone. Conclusion This review also revealed that fusion biopsy did not increase cancer detection rate but combined biopsy (Systematic and fusion) provide the highest detection rate for the diagnosis of PCa.