MRI-targeted biopsy: is systematic biopsy obsolete?

Area of Science:

• Urology
• Oncology
• Radiology

Background:

• Prostate cancer diagnosis traditionally relies on transrectal ultrasound prostate biopsy (TRUS-Bx), which has limitations in detecting clinically significant (CS) cancer and performs poorly after prior negative biopsies.
• Multiparametric MRI-targeted prostate biopsy (MRI-TB) has emerged as a more accurate alternative due to advances in MRI technology.

Purpose of the Study:

• To review the current literature on MRI-TB.
• To evaluate the evidence supporting the use of MRI-TB alone for prostate cancer diagnosis.

Main Methods:

• A literature review was conducted focusing on studies comparing MRI-TB with systematic biopsy.
• Performance metrics of both biopsy techniques were analyzed.

Main Results:

• MRI-TB demonstrates higher sensitivity (0.90) for detecting CS prostate cancer compared to TRUS-Bx (0.79).
• MRI-TB detects more high-risk cancers and fewer low-risk cancers.
• MRI-TB shows improved performance in patients with prior negative biopsies and for lesions in atypical locations.

Conclusions:

• MRI-TB is superior to TRUS-Bx for prostate cancer detection.
• Despite its advantages, traditional systematic biopsy (TRUS-Bx) still has a role in patient management.