In-bore MRI-guided prostate biopsy: current evidence, clinical applications, and future directions

Area of Science:

• Oncology
• Radiology
• Urology

Background:

• Prostate cancer is a major global health concern, necessitating accurate diagnostic methods.
• Overtreatment of indolent tumors remains a challenge in prostate cancer management.
• In-bore magnetic resonance imaging-guided prostate biopsy (IB-MRGB) is a leading MRI-targeted biopsy technique.

Purpose of the Study:

• To review the evidence, technical aspects, and clinical relevance of IB-MRGB.
• To explore the diagnostic performance and future potential of IB-MRGB.
• To assess IB-MRGB's role in precision oncology for prostate cancer.

Main Methods:

• Comprehensive literature review of PubMed, Scopus, and Embase databases.
• Inclusion of studies evaluating diagnostic performance and procedural workflow.
• Analysis of IB-MRGB's integration with focal therapies and active surveillance.

Main Results:

• IB-MRGB shows high sensitivity (80-96%) and specificity (82-90%) for detecting csPCa.
• Effective for biopsy-naïve patients, those with prior negative biopsies, and active surveillance.
• Advantages include superior targeting and reduced overdiagnosis; limitations include cost and MRI availability.

Conclusions:

• IB-MRGB enhances prostate cancer diagnosis, risk stratification, and treatment planning.
• It aligns with precision oncology principles for optimized patient care.
• Future advancements in AI and radiomics will likely expand IB-MRGB's clinical utility.