Related Experiment Video For Prostate biopsy
Updated: May 15, 2025
Use of MRI-ultrasound Fusion to Achieve Targeted Prostate Biopsy
Published on: April 9, 2019
Optimizing the strategies to perform prostate biopsy in MRI-positive patients: a systematic review and network
Qiyou Wu1, Jinbao Wang1, Xiang Tu1
1Department of Urology, West China Hospital, Sichuan University, Chengdu, China.
Background:
Early detection of prostate cancer (PCa) is crucial for better patient outcomes. However, due to overdiagnosis with the current biopsy strategy, there is a need to improve and refine the biopsy strategy. The aim of this study was to thoroughly evaluate existing biopsy schemes for patients with suspicious lesions.
Methods:
This study conducted a systematic review and network meta-analysis following PRISMA guidelines (from their start until 15 January 2025), evaluating 13 biopsy schemes for detecting PCa in MRI-positive (PIRADS/Likert score 2-5) patients. Data from PubMed, Embase, and Cochrane databases were examined to assess the efficacy of biopsy schemes in detecting clinically significant (csPCa) and clinically insignificant (ciPCa) prostate cancer. This study is registered with PROSPERO (CRD42024551971).
Findings:
The analysis included 211 studies involving 74,113 individuals. When compared with the combination of systematic biopsy (SB, defined as <20 cores) and targeted biopsy (TB, defined as <6 cores) (SB+TB), ipsilateral SB with TB (ips-SB+TB) and saturation TB did not show statistically significant inferior detection rate of csPCa (ips-SB+TB: RR 0.95, 95% CrI 0.88, 1.02; saturation TB: RR 0.96, 95% CrI 0.91, 1.01). Meanwhile, there was no significant difference in csPCa detection rates for saturation SB+TB, SB+saturation TB compared to SB+TB (saturation SB+TB: RR 1.04, 95% CrI 0.98, 1.11; SB+saturation TB: RR 1.14, 95% CrI 0.999, 1.30). TB and SB alone detected significantly less csPCa than SB+TB (TB: RR 0.86, 95% CrI 0.84, 0.88; SB: RR 0.75, 95% CrI 0.73, 0.77). Saturation SB also did not show significant superiority in detecting csPCa. Additionally, saturation TB and ips-SB+TB also decrease the detection of ciPCa. (ips-SB+TB: RR 0.87, 95% CrI 0.72, 1.04; saturation TB: RR 0.76, 95% CrI 0.65, 0.88).
Interpretation:
The network meta-analysis reveals that saturation SB+TB and SB+saturation TB have no significant difference in csPCa detection between them and SB+TB. Meanwhile, ips-SB+TB and saturation TB are effective biopsy strategies for MRI-positive PCa patients, offering a more targeted approach for detecting csPCa.
Funding:
The National Natural Science Foundation of China (Grant number: 81500522) and Science & Technology Department of Sichuan Province (Grant number: 2020YFS0090, 2020YFS0046) and Cadre Health Research Project of Sichuan Province (Grant number: ZH2023-102).
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