Abstract
In-bore magnetic resonance-guided biopsy (MRGB) has been increasingly used in clinical practice to detect prostate cancer (PCa). This review summarizes the current clinical results of this biopsy method. A systematic literature search was performed in the PubMed and Embase databases. Of 2,035 identified records, 49 required full review. In all, ten unique studies reporting clinical results of MRGB could be included. Reported PCa detection rates ranged from 8 to 59 % (median 42 %). The majority of tumors detected by MRGB were clinically significant (81–93 %). Most frequent complications of MRGB are transient hematuria (1–24 %) and short-term perirectal bleeding (11–17 %). Major complications are rare. Based on the reviewed literature, MRGB can be regarded an accurate and safe diagnostic tool to detect clinically significant PCa. However, as general availability is limited, this procedure should be reserved for specific patients. Appropriate indications will have to be determined.
Similar content being viewed by others
References
Papers of particular interest, published recently, have been highlighted as: •• Of major importance
Siegel R, Ward E, Brawley O, et al. Cancer Statistics, 2011: the impact of eliminating socioeconomic and racial disparities on premature cancer deaths. CA Cancer J Clin. 2011;61:212–36.
Roehl KA, Antenor JA, Catalona WJ. Serial biopsy results in prostate cancer screening study. J Urol. 2002;167(6):2435–9.
Djavan B, Milani S, Remzi M. Prostate biopsy: who, how and when. An update. Can J Urol. 2005;12:44–8.
Lujan M, Paez A, Santonja C, et al. Prostate cancer detection and tumor characteristics in men with multiple biopsy sessions. Prostate Cancer Prostatic Dis. 2004;7:238–42.
Tanimoto A, Nakashima J, Kohno H, et al. Prostate cancer screening: the clinical value of diffusion-weighted imaging and dynamic MR imaging in combination with T2-weighted imaging. J Magn Reson Imaging. 2007;25:146–52.
Delongchamps NB, Rouanne M, Flam T, et al. Multiparametric magnetic resonance imaging for the detection and localization of prostate cancer: combination of T2-weighted, dynamic contrast-enhanced and diffusion-weighted imaging. BJU Int. 2011;107:1411–8.
D’Amico AV, Tempany CM, Cormack RA, et al. Transperineal magnetic resonance image-guided prostate biopsy. J Urol. 2000;164(2):385–7.
Cormack RA, D’Amico AV, Hata N, et al. Feasibility of transperineal prostate biopsy under interventional magnetic resonance guidance. Urology. 2000;56:663–4.
Beyersdorff D, Winkel A, Hamm B, et al. MR imaging-guided prostate biopsy with a closed MR unit at 1.5T: initial results. Radiology. 2005;234:576–81.
•• Pondman KM, Fütterer JJ, ten Haken B, et al. MR-guided biopsy of the prostate: an overview of techniques and a systematic review. Eur Urol. 2008;54(3):517–27. Extensive overview of current strategies to perform MRGB. The authors conclude that MRGB is a promising tool to use in patients with previous negative TRUSGB.
Zangos S, Eichler K, Engelmann K, et al. MR-guided transgluteal biopsies with an open low-field system in patients with clinically suspected prostate cancer: technique and preliminary results. Eur Radiol. 2005;15:174–82.
Anastasiadis AG, Lichy MP, Nagale U, et al. MRI-guided biopsy of the prostate increases diagnostic performance in men with elevated or increasing PSA levels after previous negative TRUS biopsies. Eur Urol. 2006;50:738–49.
Singh AK, Krieger A, Lattouf JB, et al. Patient selection determines the prostate cancer yield of dynamic contrast-enhanced magnetic resonance imaging-guided transrectal biopsies in a closed 3-Tesla scanner. BJU Int. 2007;101:181–5.
Hambrock T, Somford DM, Hoeks C, et al. Magnetic resonance imaging-guided prostate biopsy in men with repeat negative biopsies and increased prostate specific antigen. J Urol. 2010;183(2):520–7.
Franiel T, Stephan C, Erbersdobler A, et al. Areas suspicious for prostate cancer: MR-guided biopsy in patients with at least one transrectal US-guided biopsy with a negative finding – multiparametric MR imaging for detection and biopsy planning. Radiology. 2011;259(1):162–72.
Engehausen DG, Engelhard K, Schwab SA, et al. Magnetic resonance image-guided biopsies with a high detection rate of prostate cancer. Sci World J. 2012, Article ID 975971.
•• Hoeks CMA, Schouten MG, Bomers JGR, et al. Three-Tesla magnetic resonance-guided prostate biopsy in men with increased prostate-specific antigen and repeated, negative, random, systematic, transrectal ultrasound biopsies: detection of clinically significant prostate cancers. Eur Urol. 2012;62:902–9. Largest study describing clinical results of MRGB in patients with previous negative TRUSGB. In a cohort of 265 patients, the authors show MRGB to achieve high diagnostic performance at acceptable complication rates.
Roethke M, Anastasiadis AG, Lichy M, et al. MRI-guided prostate biopsy detects clinically significant cancer: analysis of a cohort of 100 patients after previous negative TRUS biopsy. World J Urol. 2012;30:213–8.
Schwab SA, Kuefner MA, Adamietz B et al. MRI-guided core biopsy of the prostate in the supine position -- introduction of a simplified technique using large-bore magnet systems. Eur Radiol 2012, Epub ahead of print.
Djavan B, Remzi M, Ghawidel K, et al. Diagnosis of prostate cancer: the clinical use of transrectal ultrasound and biopsy. EAU Updat Ser. 2003;1:9–15.
Pinkstaff DM, Igel TC, Petrou SP, et al. Systematic transperineal ultrasound-guided template biopsy of the prostate: three-year experience. Urology. 2005;65:735–9.
Norberg M, Egevad L, Holmberg L, et al. The sextant protocol for ultrasound-guided core biopsies of the prostate underestimates the presence of cancer. Urology. 1997;50(4):562–6.
Fleshner NE, O’Sullivan M, Fair WR. Prevalence and predictors of a positive repeat transrectal ultrasound guided needle biopsy of the prostate. J Urol. 1997;158:505–8.
Djavan B, Waldert M, Zlotta A, et al. Safety and morbidity of first and repeat transrectal ultrasound guided prostate needle biopsies: results of a prospective European prostate cancer detection study. J Urol. 2001;166:856–60.
Raaijmakers R, Kirkels WJ, Roobol MJ, et al. Complication rates and risk factors of 5802 transrectal ultrasound-guided sextant biopsies of the prostate within a population-based screening program. Urology. 2002;60(5):826–30.
Sakai I, Harada K, Hara I, et al. A comparison of the biological features between prostate cancers arising in the transition and peripheral zones. BJU Int. 2005;96:528–32.
Cheng L, Jones TD, Pan C, et al. Anatomic distribution and pathologic characterization of small-volume prostate cancer (<0.5 ml) in whole-mount prostatectomy specimens. Mod Pathol. 2005;18:1022–6.
Lawrentschuk N, Haider MA, Daljeet N, et al. Prostatic evasive anterior tumours: the role of magnetic resonance imaging. BJU Int. 2010;105(9):1231–6.
Hambrock T, Hoeks CM, Hulsbergen-van de Kaa C, et al. Prospective assessment of prostate cancer aggressiveness using 3-T diffusion-weighted magnetic resonance imaging–guided biopsies versus a systematic 10-core transrectal ultrasound prostate biopsy cohort. Eur Urol. 2012;61(1):177–84.
Paulson DF. Impact of radical prostatectomy in the management of clinically localized disease. J Urol. 1994;152(5):1826–30.
Steinberg DM, Sauvageot J, Piantadosi S, et al. Correlation of prostate needle biopsy and radical prostatectomy Gleason grade in academic and community settings. Am J Surg Pathol. 1997;21(5):566–76.
Coogan CL, Latchamsetty KC, Greenfield J, et al. Increasing the number of biopsy cores improves the concordance of biopsy Gleason score to prostatectomy Gleason score. BJU Int. 2005;96(3):324–7.
Irani J, Fournier F, Bon D, et al. Patient tolerance of transrectal ultrasound-guided biopsy of the prostate. Br J Urol. 1997;79:608–10.
Zangos S, Melzer A, Eichler K, et al. MR-compatible assistance system for biopsy in a high-field-strength system: initial results in patients with suspicious prostate lesions. Radiology. 2011;259:903–10.
Yakar D, Schouten MG, Bosboom DG, et al. Feasibility of a pneumatically actuated MR-compatible robot for transrectal prostate biopsy guidance. Radiology. 2011;260:241–7.
Fütterer JJ, Barentsz JO. MRI-guided and robotic-assisted prostate biopsy. Curr Opin Urol. 2012;22:316–9.
Singh AK, Kruecker J, Xu S, et al. Initial clinical experience with real-time transrectal ultrasonography-magnetic resonance imaging fusion-guided prostate biopsy. BJU Int. 2008;101(7):841–5.
Ukimura O, Hirahara N, Fujihara A, et al. Technique for a hybrid system of real-time transrectal ultrasound with preoperative magnetic resonance imaging in the guidance of targeted prostate biopsy. Int J Urol. 2010;17:890–3.
•• Hadaschik BA, Kuru TH, Tulea C, et al. A novel stereotactic prostate biopsy system integrating pre-interventional magnetic resonance imaging and live ultrasound fusion. J Urol. 2011;186(6):2214–20. MR/TRUS-fusion guided biopsy may be a promising alternative to increase the general availability of targeted biopsy strategies. In their study, the authors report initial clinical experience using this technique in a transperineal approach, with promising results.
Disclosure
Dr. Christiaan G. Overduin reported no conflicts of interest relevant to this article.
Dr. Jurgen J. Fütterer received consultancy from Invivo, Schwerin, Germany.
Dr. Jelle O. Barentsz reported no conflicts of interest relevant to this article.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Overduin, C.G., Fütterer, J.J. & Barentsz, J.O. MRI-Guided Biopsy for Prostate Cancer Detection: A Systematic Review of Current Clinical Results. Curr Urol Rep 14, 209–213 (2013). https://doi.org/10.1007/s11934-013-0323-z
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11934-013-0323-z