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Updated: May 2, 2026
Use of MRI-ultrasound Fusion to Achieve Targeted Prostate Biopsy
Published on: April 9, 2019
Is biparametric MRI a feasible option for detecting clinically significant prostate cancer?: A systematic review and
Carlos A Garcia-Becerra1, Maria I Arias-Gallardo1, Veronica Soltero-Molinar2
1Research Department, Urovallarta Medical Center, Puerto Vallarta, Mexico.
Background:
Multiparametric MRI (Mp-MRI) is a key tool to screen for Prostate Cancer (Pca) and Clinically Significant Prostate Cancer (CsPca). It primarily includes T2-Weighted imaging (T2w), diffusion-weighted imaging (DWI), and Dynamic Contrast-Enhanced imaging (DCE). Despite its improvements in CsPca screening, concerns about the cost-effectiveness of DCE persist due to its associated side effects, increased cost, longer acquisition time, and limitations in patients with poor kidney function. Recent studies have explored Biparametric MRI (Bp-MRI) as an alternative that excludes DCE.
Objectives:
The main objective of this study is to compile and evaluate updated results of Bp-MRI as a diagnostic alternative to detect CsPca.
Methods:
A systematic review was conducted using PubMed, Central Cochrane, and ClinicalTrialls.gov registry. Inclusion criteria was focused on observational and experimental studies that assessed a direct comparison of Bp-MRI and Mp-MRI for CsPca detection. The primary outcomes included were necessary to create a contingency 2×2 table and CsPca prevalence from each study. The secondary outcomes included were demographic data and imaging protocol features. The statistical analysis used a Bivariate Random-Effect model to estimate the pooled sensitivity, specificity, and area under the curve (AUC). An univariate random-effect model was conducted to estimate the positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio. Risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies -2 tool.
Results:
From 534 articles initially identified, 19 studies met the inclusion criteria with a total of 5075 patients. The pooled sensitivity estimated was 0.89, pooled specificity was 0.73, and AUC was 0.90; these results showed a slight increase compared to previous studies.
Conclusion:
The results obtained showed that Bp-MRI is a feasible alternative to detect CsPca, which demonstrates high diagnostic accuracy and avoids the drawbacks associated with DCE.
Registry:
This is a sub-analysis of the protocol registered at PROSPERO (CRD42024552125).
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