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Updated: Feb 13, 2026

Use of MRI-ultrasound Fusion to Achieve Targeted Prostate Biopsy
Published on: April 9, 2019
MRI-Targeted or Standard Biopsy for Prostate-Cancer Diagnosis
Veeru Kasivisvanathan1, Antti S Rannikko1, Marcelo Borghi1
1From University College London (UCL) and UCL Hospitals NHS Foundation Trust (V.K., C.A., F.G., A.F., S.M., S.P., M.E., C.M.M.), London North West Healthcare NHS Trust (G.H.), Whittington Health NHS Trust (M.G.), Royal Free London NHS Foundation Trust (P.B.S.), and UCL Surgical and Interventional Trials Unit (N.R.W., C.B.-G.), London, Hampshire Hospitals NHS Foundation Trust, Basingstoke (R.G.H.), Princess Alexandra Hospital NHS Trust, Harlow (J.V.), and the Institute of Applied Health Research and the NIHR Birmingham Biomedical Research Centre, University of Birmingham, Birmingham (J.D., Y.T.) - all in the United Kingdom; Helsinki University and Helsinki University Hospital, Helsinki (A.S.R.), and Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu (M.H.V.) - all in Finland; Centro de Urología, Buenos Aires (M.B.); Sapienza University, Rome (V.P.), and IRCCS Ospedale San Raffaele and Vita-Salute San Raffaele University, Milan (A.B.) - all in Italy; Mayo Clinic, Rochester, MN (L.A.M.); Martini Klinik, Hamburg (L.B.), University Hospital Essen, Essen (B.A.H.), and University Hospital Heidelberg, Heidelberg (B.A.H.) - all in Germany; Erasmus University Medical Center, Rotterdam (M.J.R.), and Radboud University Medical Center, Nijmegen (W.V.) - both in the Netherlands; University of Chicago, Chicago (S.E.); Université de Lille and Centre Hospitalier Universitaire Lille, Lille (A.V.), Université de Bordeaux and Bordeaux Pellegrin University Hospital, Bordeaux (G.R.), and Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud (A.R.), and Hospices Civils de Lyon of the Hôpital Edouard Herriot (S.C.), Lyon - all in France; Jewish General Hospital, Montreal (F.B.), and Sunnybrook Health Sciences Centre, Toronto (L.K.) - both in Canada; Ghent University Hospital, Ghent, Belgium (G.M.V.); University Hospital Bern, Bern, Switzerland (S.B.); Weill Cornell Medicine, New York-Presbyterian Hospital (J.C.H., D.M.), and New York University Langone Medical Center (S.S.T.), New York; National Institutes of Health, Bethesda, MD (P.P.); and the University of Southern California Institute of Urology, Keck School of Medicine, Los Angeles (I.G.).
Multiparametric MRI before biopsy is superior to standard biopsy for detecting significant prostate cancer. This approach reduces diagnoses of clinically insignificant cancer in men with elevated PSA levels.
Area of Science:
- Urology
- Radiology
- Oncology
Background:
- Multiparametric MRI (mpMRI) is an alternative to standard biopsy for prostate cancer detection.
- Limited comparative evidence exists for mpMRI versus standard biopsy in biopsy-naive men with elevated PSA.
Purpose of the Study:
- To compare the efficacy of mpMRI with or without targeted biopsy against standard transrectal ultrasonography-guided biopsy for prostate cancer detection.
- To evaluate the detection rates of clinically significant and insignificant prostate cancer.
Main Methods:
- A multicenter, randomized, noninferiority trial involving 500 biopsy-naive men with suspected prostate cancer.
- Participants were assigned to either mpMRI with or without targeted biopsy or standard 10-12 core biopsy.
- Targeted biopsy was performed only if MRI suggested cancer; otherwise, no biopsy was done.
Main Results:
- mpMRI-targeted biopsy detected clinically significant cancer in 38% of men, compared to 26% with standard biopsy (P=0.005).
- The mpMRI strategy was noninferior and indicated superiority over standard biopsy.
- Fewer men in the mpMRI group received a diagnosis of clinically insignificant cancer (P<0.001).
Conclusions:
- Risk assessment with mpMRI followed by targeted biopsy is superior to standard biopsy in biopsy-naive men at clinical risk for prostate cancer.
- This strategy improves the detection of significant cancer while reducing the diagnosis of insignificant cancer.
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