Charles Dariane1, Guillaume Ploussard2,3,4, Eric Barret5, Jean-Baptiste Beauval2,4, Laurent Brureau6, Gilles Créhange7, Gaëlle Fromont8, Mathieu Gauthé9, Romain Mathieu10, Raphaële Renard-Penna11, Guilhem Roubaud12, Alain Ruffion13,14, Paul Sargos15, Morgan Rouprêt16, Gaëlle Fiard17. 1. Department of Urology, Hôpital Européen Georges-Pompidou, APHP, Paris-Paris Cité University-U1151 Inserm-INEM, Necker, Paris, France. Dariane.charles@gmail.com. 2. Department of Urology, La Croix du Sud Hôpital, Quint Fonsegrives, France. 3. Department of Urology, Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, France. 4. IUCT-O, Toulouse, France. 5. Department of Urology, Institut Mutualiste Montsouris, Paris, France. 6. Department of Urology, CHU de Pointe-À-Pitre, University of Antilles, University of Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail)-UMR_S 1085, 97110, Pointe-à-Pitre, France. 7. Department of Radiotherapy, Institut Curie, Paris, France. 8. Department of Pathology, CHRU Tours, Tours, France. 9. Department of Nuclear Medicine, Scintep-Institut Daniel Hollard, Grenoble, France. 10. Department of Urology, CHU Rennes, Rennes, France. 11. AP-HP, Radiology, Pitie-Salpetriere Hospital, Sorbonne University, 75013, Paris, France. 12. Department of Medical Oncology, Institut Bergonié, 33000, Bordeaux, France. 13. Service d'urologie Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France. 14. Equipe 2, Centre d'Innovation en Cancérologie de Lyon (EA 3738 CICLY), Faculté de médecine Lyon Sud, Université Lyon 1, Lyon, France. 15. Department of Radiotherapy, Institut Bergonié, 33000, Bordeaux, France. 16. GRC 5 Predictive Onco-Uro, AP-HP, Urology, Pitie-Salpetriere Hospital, Sorbonne University, 75013, Paris, France. 17. Department of Urology, Grenoble Alpes University Hospital, Université Grenoble Alpes, CNRS, Grenoble INP, TIMC-IMAG, Grenoble, France.
Abstract
PURPOSE: The diagnosis of prostate cancer (PCa) still relies on the performance of both targeted (TB) and systematic biopsies (SB). Micro-ultrasound (mUS)-guided biopsies demonstrated a high sensitivity in detecting clinically significant prostate cancer (csPCa), which could be comparable to that of magnetic resonance imaging (MRI)-TB, but their added value has not been compared to SB yet. METHODS: We conducted a systematic review and meta-analysis, based on Medline, EMBASE, Scopus, and Web of Science, in accordance with PRISMA guidelines, to compare mUS-guided biopsies to SB. RESULTS: Based on the literature search of 2957 articles, 15 met the inclusion criteria (2967 patients). Most patients underwent mUS-guided biopsies, followed by MRI-TB and SB. Respectively 5 (n = 670) and 4 (n = 467) studies, providing raw data on SB, were included in a random-effect meta-analysis of the detection rate of csPCa, i.e. Gleason Grade Group (GGG) ≥ 2 or non-csPCa (GGG = 1). Overall, PCa was detected in 56-71% of men, with 31.3-49% having csPCa and 17-25.4% having non-csPCa. Regarding csPCa, mUS-guided biopsies identified 196 and SB 169 cases (Detection Ratio (DR): 1.18, 95% CI 0.83-1.68, I2 = 69%), favoring mUS-guided biopsies; regarding non-csPCa, mUS-guided biopsies identified 62 and SB 115 cases (DR: 0.55, 95% CI 0.41-0.73, I2 = 0%), also favoring mUS-guided biopsies by decreasing unnecessary diagnosis. CONCLUSION: Micro-ultrasound-guided biopsies compared favorably with SB for the detection of csPCa and detected fewer non-csPCa than SB. Prospective trials are awaited to confirm the interest of adding mUS-guided biopsies to MRI-TB to optimize csPCa detection without increasing overdiagnosis of non-csPCa.
PURPOSE: The diagnosis of prostate cancer (PCa) still relies on the performance of both targeted (TB) and systematic biopsies (SB). Micro-ultrasound (mUS)-guided biopsies demonstrated a high sensitivity in detecting clinically significant prostate cancer (csPCa), which could be comparable to that of magnetic resonance imaging (MRI)-TB, but their added value has not been compared to SB yet. METHODS: We conducted a systematic review and meta-analysis, based on Medline, EMBASE, Scopus, and Web of Science, in accordance with PRISMA guidelines, to compare mUS-guided biopsies to SB. RESULTS: Based on the literature search of 2957 articles, 15 met the inclusion criteria (2967 patients). Most patients underwent mUS-guided biopsies, followed by MRI-TB and SB. Respectively 5 (n = 670) and 4 (n = 467) studies, providing raw data on SB, were included in a random-effect meta-analysis of the detection rate of csPCa, i.e. Gleason Grade Group (GGG) ≥ 2 or non-csPCa (GGG = 1). Overall, PCa was detected in 56-71% of men, with 31.3-49% having csPCa and 17-25.4% having non-csPCa. Regarding csPCa, mUS-guided biopsies identified 196 and SB 169 cases (Detection Ratio (DR): 1.18, 95% CI 0.83-1.68, I2 = 69%), favoring mUS-guided biopsies; regarding non-csPCa, mUS-guided biopsies identified 62 and SB 115 cases (DR: 0.55, 95% CI 0.41-0.73, I2 = 0%), also favoring mUS-guided biopsies by decreasing unnecessary diagnosis. CONCLUSION: Micro-ultrasound-guided biopsies compared favorably with SB for the detection of csPCa and detected fewer non-csPCa than SB. Prospective trials are awaited to confirm the interest of adding mUS-guided biopsies to MRI-TB to optimize csPCa detection without increasing overdiagnosis of non-csPCa.
Authors: Sebastian L Hofbauer; Ferdinand Luger; Niklas Harland; Henning Plage; Maximillian Reimann; Markus Hollenbach; Andreas Gusenleitner; Arnulf Stenzl; Thorsten Schlomm; Laura Wiemer; Hannes Cash Journal: BJU Int Date: 2021-12-01 Impact factor: 5.588
Authors: José Gregorio Pereira-Arias; Andrea Sánchez-Vázquez; Mikel Gamarra-Quintanilla; Jorge Alberto Mora-Christian; Luis Felipe Urdaneta-Salegui; Ander Astobieta-Odriozola; Gaspar Ibarluzea-González Journal: Arch Esp Urol Date: 2019-10 Impact factor: 0.436