Abstract
Purpose
The diagnostic strategy implementing multiparametric magnet resonance tomography (mpMRI) and targeted biopsies (TB) improves the detection and characterization of significant prostate cancer (PCa). We aimed to assess the clinical usefulness of systematic biopsies (SB) in the setting of patients having a pre-biopsy positive MRI.
Methods
A review of the literature was performed in March 2018. All studies investigating the performance of SB in addition to TB (all techniques) were assessed, both in the biopsy-naïve and repeat biopsy setting.
Results
Evidence demonstrates that TB improves the detection of index-significant PCa compared with SB alone, in both initial and repeat biopsy settings. However, the combination of both TB and SB improved the overall (around 30%) and significant (around 10%) PCa detection rates as compared with TB alone. Significant differences between both biopsy approaches exist regarding cancer location favoring SB for the far lateral sampling, and TB for the anterior zone. Main current pitfalls of pure TB strategy are the learning curve and experience required for mpMRI reading and biopsy targeting, as well as the precision assessment in TB techniques.
Conclusion
A pure TB strategy omitting SB leads to the risk of missing up to 15% of significant cancer, due to limitations of mpMRI performance/reading and of precision during lesion targeting. SB remain necessary, in addition to the TB, to obtain the most accurate assessment of the entire prostate gland in this sub-group of patients at risk of significant disease.
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References
Fütterer JJ, Briganti A, De Visschere P, Emberton M, Giannarini G, Kirkham A et al (2015) Can clinically significant prostate cancer be detected with multiparametric magnetic resonance imaging? a systematic review of the literature. Eur Urol 68:1045–1053
Rastinehad AR, Turkbey B, Salami SS, Yaskiv O, George AK, Fakhoury M et al (2014) Improving detection of clinically significant prostate cancer: magnetic resonance imaging/transrectal ultrasound fusion guided prostate biopsy. J Urol 191:1749–1754
Pokorny MR, de Rooij M, Duncan E, Schröder FH, Parkinson R, Barentsz JO et al (2014) Prospective study of diagnostic accuracy comparing prostate cancer detection by transrectal ultrasound-guided biopsy versus magnetic resonance (MR) imaging with subsequent MR-guided biopsy in men without previous prostate biopsies. Eur Urol 66:22–29
Moore CM, Robertson NL, Arsanious N, Middleton T, Villers A, Klotz L et al (2013) Image-guided prostate biopsy using magnetic resonance imaging-derived targets: a systematic review. Eur Urol 63:125–140
Wegelin O, van Melick HHE, Hooft L, Bosch JLHR, Reitsma HB, Barentsz JO et al (2017) Comparing three different techniques for magnetic resonance imaging-targeted prostate biopsies: a systematic review of in-bore versus magnetic resonance imaging-transrectal ultrasound fusion versus cognitive registration. Is there a preferred technique? Eur Urol 71:517–531
Moldovan PC, Van den Broeck T, Sylvester R, Marconi L, Bellmunt J, van den Bergh RCN et al (2017) What is the negative predictive value of multiparametric magnetic resonance imaging in excluding prostate cancer at biopsy? A systematic review and meta-analysis from the European Association of Urology Prostate Cancer Guidelines Panel. Eur Urol 72:250–266
Ahmed HU, El-Shater Bosaily A, Brown LC, Gabe R, Kaplan R, Parmar MK, PROMIS Study Group et al (2017) Diagnostic accuracy of multi-parametric MRI and TRUS biopsy in prostate cancer (PROMIS): a paired validating confirmatory study. Lancet 389:815–822
Radtke JP, Schwab C, Wolf MB, Freitag MT, Alt CD, Kesch C et al (2016) Multiparametric magnetic resonance imaging (MRI) and MRI-transrectal ultrasound fusion biopsy for index tumor detection: correlation with radical prostatectomy specimen. Eur Urol 70:846–853
Le JD, Stephenson S, Brugger M, Lu DY, Lieu P, Sonn GA et al (2014) Magnetic resonance imaging-ultrasound fusion biopsy for prediction of final prostate pathology. J Urol 192:1367–1373
Le JD, Tan N, Shkolyar E, Lu DY, Kwan L, Marks LS et al (2015) Multifocality and prostate cancer detection by multiparametric magnetic resonance imaging: correlation with whole-mount histopathology. Eur Urol 67:569–576
Delongchamps NB, Lefèvre A, Bouazza N, Beuvon F, Legman P, Cornud F (2015) Detection of significant prostate cancer with magnetic resonance targeted biopsies-should transrectal ultrasound-magnetic resonance imaging fusion guided biopsies alone be a standard of care? J Urol 193:1198–1204
Filson CP, Natarajan S, Margolis DJ, Huang J, Lieu P, Dorey FJ et al (2016) Prostate cancer detection with magnetic resonance-ultrasound fusion biopsy: the role of systematic and targeted biopsies. Cancer 122:884–892
Russo F, Regge D, Armando E, Giannini V, Vignati A, Mazzetti S et al (2016) Detection of prostate cancer index lesions with multiparametric magnetic resonance imaging (mp-MRI) using whole-mount histological sections as the reference standard. BJU Int 118:84–94
Martorana E, Pirola GM, Scialpi M, Micali S, Iseppi A, Bonetti LR et al (2017) Lesion volume predicts prostate cancer risk and aggressiveness: validation of its value alone and matched with prostate imaging reporting and data system score. BJU Int 120:92–103
Siddiqui MM, Rais-Bahrami S, Turkbey B, George AK, Rothwax J, Shakir N et al (2015) Comparison of MR/ultrasound fusion-guided biopsy with ultrasound-guided biopsy for the diagnosis of prostate cancer. JAMA 313:390–397
Siddiqui MM, George AK, Rubin R, Rais-Bahrami S, Parnes HL, Merino MJ et al (2016) Efficiency of prostate cancer diagnosis by MR/ultrasound fusion-guided biopsy vs standard extended-sextant biopsy for MR-visible lesions. J Natl Cancer Inst. https://doi.org/10.1093/jnci/djw039
Tonttila PP, Lantto J, Pääkkö E, Piippo U, Kauppila S, Lammentausta E et al (2016) Prebiopsy multiparametric magnetic resonance imaging for prostate cancer diagnosis in biopsy-naive men with suspected prostate cancer based on elevated prostate-specific antigen values: results from a randomized prospective blinded controlled trial. Eur Urol 69:419–425
Baco E, Rud E, Eri LM, Moen G, Vlatkovic L, Svindland A et al (2016) A randomized controlled trial to assess and compare the outcomes of two-core prostate biopsy guided by fused magnetic resonance and transrectal ultrasound images and traditional 12-core systematic biopsy. Eur Urol 69:149–156
Porpiglia F, Manfredi M, Mele F, Cossu M, Bollito E, Veltri A et al (2017) Diagnostic pathway with multiparametric magnetic resonance imaging versus standard pathway: results from a Randomized Prospective Study in biopsy-naïve patients with suspected prostate cancer. Eur Urol 72:282–288
Arsov C, Rabenalt R, Blondin D, Quentin M, Hiester A, Godehardt E et al (2015) Prospective randomized trial comparing magnetic resonance imaging (MRI)-guided in-bore biopsy to MRI-ultrasound fusion and transrectal ultrasound-guided prostate biopsy in patients with prior negative biopsies. Eur Urol 68:713–720
Delongchamps NB, Portalez D, Bruguière E, Rouvière O, Malavaud B, Mozer P et al (2016) Are magnetic resonance imaging-transrectal ultrasound guided targeted biopsies noninferior to transrectal ultrasound guided systematic biopsies for the detection of prostate cancer? J Urol 196:1069–1075
Radtke JP, Kuru TH, Boxler S, Alt CD, Popeneciu IV, Huettenbrink C et al (2015) Comparative analysis of transperineal template saturation prostate biopsy versus magnetic resonance imaging targeted biopsy with magnetic resonance imaging-ultrasound fusion guidance. J Urol 193:87–94
Schouten MG, van der Leest M, Pokorny M, Hoogenboom M, Barentsz JO, Thompson LC et al (2017) Why and where do we miss significant prostate cancer with multi-parametric magnetic resonance imaging followed by magnetic resonance-guided and transrectal ultrasound-guided biopsy in biopsy-naïve men? Eur Urol 71:896–903
Park BK, Park JW, Park SY, Kim CK, Lee HM, Jeon SS et al (2011) Prospective evaluation of 3-T MRI performed before initial transrectal ultrasound-guided prostate biopsy in patients with high prostate-specific antigen and no previous biopsy. AJR Am J Roentgenol 197:876–881
Kasivisvanathan V, Rannikko AS, Borghi M, Panebianco V, Mynderse LA, Vaarala MH et al (2018) MRI-targeted or standard biopsy for prostate-cancer diagnosis. N Engl J Med. https://doi.org/10.1056/NEJMoa1801993
Cooper CS, Eeles R, Wedge DC, Van Loo P, Gundem G, Alexandrov LB et al (2015) Analysis of the genetic phylogeny of multifocal prostate cancer identifies multiple independent clonal expansions in neoplastic and morphologically normal prostate tissue. Nat Genet 47:367–372
Kamrava M, Hegde JV, Abgaryan N, Chang E, Le JD, Wang J et al (2016) Does the addition of targeted prostate biopsies to standard systemic biopsies influence treatment management for radiation oncologists? BJU Int 117:584–591
Mehralivand S, Shih JH, Rais-Bahrami S, Oto A, Bednarova S, Nix JW et al (2018) A magnetic resonance imaging-based prediction model for prostate biopsy risk stratification. JAMA Oncol. https://doi.org/10.1001/jamaoncol.2017.5667
Gaziev G, Wadhwa K, Barrett T, Koo BC, Gallagher FA, Serrao E et al (2016) Defining the learning curve for multiparametric magnetic resonance imaging (MRI) of the prostate using MRI-transrectal ultrasonography (TRUS) fusion-guided transperineal prostate biopsies as a validation tool. BJU Int 117:80–86
Venderink W, de Rooij M, Sedelaar JPM, Huisman HJ, Fütterer JJ (2016) Elastic versus rigid image registration in magnetic resonance imaging-transrectal ultrasound fusion prostate biopsy: a systematic review and meta-analysis. Eur Urol Focus. https://doi.org/10.1016/j.euf.2016.07.003
Westhoff N, Siegel FP, Hausmann D, Polednik M, von Hardenberg J et al (2017) Precision of MRI/ultrasound-fusion biopsy in prostate cancer diagnosis: an ex vivo comparison of alternative biopsy techniques on prostate phantoms. World J Urol 35:1015–1022
Cornud F, Roumiguié M, Barry de Longchamps N, Ploussard G, Bruguière E, Portalez D et al (2018) Precision matters in MR imaging-targeted prostate biopsies: evidence from a prospective study of cognitive and elastic fusion registration transrectal biopsies. Radiology. https://doi.org/10.1148/radiol.2017162916
Renard-Penna R, Rouvière O, Puech P, Borgogno C, Abbas L, Roy C et al (2016) Current practice and access to prostate MR imaging in France. Diagn Interv Imaging 97:1125–1129
Borghesi M, Ahmed H, Nam R, Schaeffer E, Schiavina R, Taneja S et al (2017) Complications after systematic, random, and image-guided prostate biopsy. Eur Urol 71:353–365
Panebianco V, Barchetti F, Sciarra A, Ciardi A, Indino EL, Papalia R et al (2015) Multiparametric magnetic resonance Imaging vs. standard care in men being evaluated for prostate cancer: a randomized study. Urol Oncol 33:17.e1–17.e.7
Taverna G, Bozzini G, Grizzi F, Seveso M, Mandressi A, Balzarini L et al (2016) Endorectal multiparametric 3-tesla magnetic resonance imaging associated with systematic cognitive biopsies does not increase prostate cancer detection rate: a randomized prospective trial. World J Urol 34(6):797–803
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Guillaume Ploussard: Protocol/Project Development, Data collection, data writing. Hendrik Borgmann: Critical revision, editing. Alberto Briganti: Critical revision, editing. Pieter de Visschere: Critical revision, editing. Jurgen J. Fütterer: Critical revision, editing. Giorgio Gandaglia: Critical revision, editing. Isabel Heidegger: Critical revision, editing. Alexander Kretschmer: Critical revision, editing. Romain Mathieu: Critical revision, editing. Piet Ost: Critical revision, editing. Prasanna Sooriakumaran: Critical revision, editing. Cristian Surcel: Critical revision, editing. Derya Tilki: Critical revision, editing. Igor Tsaur: Critical revision, editing. Massimo Valerio: Critical revision, editing. Roderick van den Bergh: Protocol/Project Development, Data collection, data writing.
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Ploussard, G., Borgmann, H., Briganti, A. et al. Positive pre-biopsy MRI: are systematic biopsies still useful in addition to targeted biopsies?. World J Urol 37, 243–251 (2019). https://doi.org/10.1007/s00345-018-2399-z
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DOI: https://doi.org/10.1007/s00345-018-2399-z