M Noureldin1,2,3, D Eldred-Evans4,5, C C Khoo4,5, M Winkler4,5, H Sokhi6,7, H Tam8, H U Ahmed4,5. 1. Imperial Prostate, Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, Charing Cross Campus, Fulham Palace Road, London, W6 8RF, UK. mohamed.noureldin@nhs.net. 2. Imperial Urology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK. mohamed.noureldin@nhs.net. 3. Urology Department, Ain Shams University Hospitals, Cairo, Egypt. mohamed.noureldin@nhs.net. 4. Imperial Prostate, Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, Charing Cross Campus, Fulham Palace Road, London, W6 8RF, UK. 5. Imperial Urology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK. 6. Department of Radiology, Hillingdon Hospitals NHS Foundation Trust, London, UK. 7. Paul Strickland Scanner Centre, Mount Vernon Hospital, Northwood, UK. 8. Department of Radiology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK.
Abstract
PURPOSE: Transrectal ultrasound (TRUS)-guided biopsy has been the traditional biopsy route in the detection of prostate cancer. However, due to concern regarding overdetection of low-risk cancer and missed clinically significant cancers as well as risk of sepsis, alternative approaches have been explored. Transperineal template biopsy-sampling the gland every 5 m to 10 mm-reduces error by sampling the whole prostate but increases risk of detecting clinically insignificant cancers as well as conferring risks of side effects such as urinary retention and bleeding. METHODS: There are various targeted biopsy techniques, each with different cancer detection rates, costs and learning curves. Current research focuses on refining biopsy methodology to maximize detection of significant cancers, whilst minimising invasiveness and complications. In this article, the up-to-date research data about MRI-targeted prostate biopsy were reviewed to show its utilization in prostate cancer management and diagnosis. RESULTS AND CONCLUSION: Prostate multiparametric MRI has become an effective tool in the detection of significant cancers and an essential component of the prostate cancer diagnostic pathway incorporating MRI-guided biopsy decisions.
PURPOSE: Transrectal ultrasound (TRUS)-guided biopsy has been the traditional biopsy route in the detection of prostate cancer. However, due to concern regarding overdetection of low-risk cancer and missed clinically significant cancers as well as risk of sepsis, alternative approaches have been explored. Transperineal template biopsy-sampling the gland every 5 m to 10 mm-reduces error by sampling the whole prostate but increases risk of detecting clinically insignificant cancers as well as conferring risks of side effects such as urinary retention and bleeding. METHODS: There are various targeted biopsy techniques, each with different cancer detection rates, costs and learning curves. Current research focuses on refining biopsy methodology to maximize detection of significant cancers, whilst minimising invasiveness and complications. In this article, the up-to-date research data about MRI-targeted prostate biopsy were reviewed to show its utilization in prostate cancer management and diagnosis. RESULTS AND CONCLUSION: Prostate multiparametric MRI has become an effective tool in the detection of significant cancers and an essential component of the prostate cancer diagnostic pathway incorporating MRI-guided biopsy decisions.
Entities:
Keywords:
MRI prostate; MRI-targeted biopsy; Prostate biopsy; Prostate cancer diagnostics
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