EURURO Vol. 71 No. 4

Platinum Priority – Review – Prostate Cancer

Editorial by Matthew R. Cooperberg on pp. 532–533 of this issue

Comparing Three Different Techniques for Magnetic Resonance

Imaging-targeted Prostate Biopsies: A Systematic Review of

In-bore versus Magnetic Resonance Imaging-transrectal

Ultrasound fusion versus Cognitive Registration.

Is There a Preferred Technique?

Olivier

[16_TD$DIFF]

Wegelin

a , * ,

Harm H.E. van Melick

[17_TD$DIFF]

Lotty Hooft

b ,

J.L.H. Ruud Bosch

[18_TD$DIFF]

Hans

[19_TD$DIFF]

B. Reitsma

d ,

Jelle O. Barentsz

e ,

Diederik M. Somford

Department of Urology, St. Antonius Hospital, Nieuwegein/Utrecht, The Netherlands;

Cochrane Netherlands, Julius Centre for Health Sciences and Primary

Care, University Medical Centre Utrecht, The Netherlands;

Department of Urology, University Medical Centre Utrecht, The Netherlands;

Department of

Epidemiology, Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, The Netherlands;

Department of Radiology, Radboud

University Nijmegen Medical Centre, The Netherlands;

Department of Urology, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands

E U R O P E A N U R O L O G Y 7 1 ( 2 0 1 7 ) 5 1 7 – 5 3 1

ava ilable at

www.sciencedirect.com

journal homepage:

www.eu ropeanurology.com

Article info

Article history:

Accepted July 22, 2016

Associate Editor:

James Catto

Keywords:

Diagnosis

Image guided biopsy

Meta-analysis

MRI

Prostate cancer

Systematic review

Abstract

Context:

The introduction of magnetic resonance imaging-guided biopsies (MRI-GB) has

changed the paradigm concerning prostate biopsies. Three techniques of MRI-GB are

available: (1) in-bore MRI target biopsy (MRI-TB), (2) MRI-transrectal ultrasound fusion

(FUS-TB), and (3) cognitive registration (COG-TB).

Objective:

To evaluate whether MRI-GB has increased detection rates of (clinically

significant) prostate cancer (PCa) compared with transrectal ultrasound-guided biopsy

(TRUS-GB) in patients at risk for PCa, and which technique of MRI-GB has the highest

detection rate of (clinically significant) PCa.

Evidence acquisition:

We performed a literature search in PubMed, Embase, and CEN-

TRAL databases. Studies were evaluated using the Quality Assessment of Diagnostic

Accuracy Studies-2 checklist and START recommendations. The initial search identified

2562 studies and 43 were included in the meta-analysis.

Evidence synthesis:

Among the included studies 11 used MRI-TB, 17 used FUS-TB,

11 used COG-TB, and four used a combination of techniques. In 34 studies concurrent

TRUS-GB was performed. There was no significant difference between MRI-GB

(all techniques combined) and TRUS-GB for overall PCa detection (relative risk [RR]

0.97 [0.90–1.07]). MRI-GB had higher detection rates of clinically significant PCa (csPCa)

compared with TRUS-GB (RR 1.16 [1.02–1.32]), and a lower yield of insignificant PCa

(RR 0.47 [0.35–0.63]). There was a significant advantage (

= 0.02) of MRI-TB compared

with COG-TB for overall PCa detection. For overall PCa detection there was no significant

advantage of MRI-TB compared with FUS-TB (

= 0.13), and neither for FUS-TB compared

with COG-TB (

= 0.11). For csPCa detection there was no significant advantage of any

one technique of MRI-GB. The impact of lesion characteristics such as size and localisa-

tion could not be assessed.

* Corresponding author. St. Antonius Hospital, Department of Urology, Koekoekslaan 1, Post Office

Box 2500, 3430 EM Nieuwegein, The Netherlands. Tel. +31-(0)-88-3202554;

Fax: +31-(0)-30-6092680.

E-mail address:

o.wegelin@antoniusziekenhuis.nl

(O. Wegelin).

http://dx.doi.org/10.1016/j.eururo.2016.07.041

0302-2838/