Cost‐effectiveness of magnetic resonance imaging and targeted fusion biopsy for early detection of prostate cancer

Barnett, Christine; Davenport, Matthew S.; Montgomery, Jeffrey S.; Wei, John T.; Montie, James E.; Denton, Brian T.

doi:10.1111/bju.14151

Cited by 52 publications

(77 citation statements)

References 40 publications

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“…Three studies stated that their population of interest was men in whom there is still a suspicion of prostate cancer following a negative initial biopsy result, due to clinical or pathological ndings (16,17,30). Only two studies modelled screening strategies in a population of test-naïve men (22,31). Only the NICE guideline justi ed the start and stop ages used, stating the committee advised an age of 75 to be a realistic upper threshold as the average man would be unlikely to be considered for radical therapy on diagnosis beyond this age.…”

Section: Patient Populationmentioning

confidence: 99%

“…Eight of sixteen studies reported the percentage of men allocated to each type of treatment ( Table 3). The percentage of high-grade men allocated to a radical treatment (prostatectomy, radiotherapy, brachytherapy, hormone therapy or androgen deprivation therapy) varied from 65% (29) to 100% (22). The percentage of men with low grade cancer allocated to a radical treatment varied from 20% (24,29) to 100% (25).…”

Section: Treatment Typesmentioning

confidence: 99%

“…As detailed in Table 4, all but two studies assigned disutilities to various aspects associated with testing including screening attendance, the biopsy procedure, diagnosis of cancer, treatment, active surveillance, advanced or metastatic cancer, post-treatment or recovery, adverse events associated with biopsy and treatment and palliative therapy. Five of the fourteen studies (17,21,22,24,26,27)…”

Section: Quality Of Lifementioning

confidence: 99%

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Systematic Review of cost-effectiveness models in prostate cancer: exploring new developments in testing and diagnosis

Keeney

Thom

Turner

et al. 2020

Preprint

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Background There is currently no formal prostate cancer screening programme in the UK. Early detection using age-based prostate-specific antigen (PSA) testing is unlikely to be cost-effective due to limited mortality benefit and harms associated with overdetection. However, the discovery of new prostate cancer specific biomarkers and more accurate diagnostic strategies (e.g. magnetic resonance imaging (MRI)) could improve the outcomes of screening. A systematic review was conducted to assess the evidence base on cost-effectiveness of such innovations and areas for further development. Methods To identify model-based economic evaluations of screening and diagnostic tests for prostate cancer, a systematic review of the literature using the NHS Economic Evaluation Database, Medline, EMBASE, HTA databases, NICE guidelines, and UK National Screening Committee guidance was carried out, between 2009 and 2019. Relevant data were extracted on study type, model inputs, modelling methods and cost-effectiveness conclusions and the results narratively synthesized. Results Sixteen studies were included in the review. Seven studies compared the cost-effectiveness of new urinary or blood biomarkers compared to each other or the PSA test and found the biomarkers e.g. the Prostate Health Index (PHI) and SelectMDx, to be the most cost-effective. Seven studies compared newer prostate biopsy methods, including MRI-guided, to TRUS guided biopsy and found MRI-guided methods to be most cost-effective. The newer detection methods showed a reduction in unnecessary biopsies and overtreatment. However, there was uncertainty around the most cost-effective pathway of follow-up strategies (MRI/biomarkers) in men who have a negative initial biopsy. Many studies did not model stage or grade of cancer, cancer progression or the entire testing, screening and treatment pathway. Very few studies fully accounted for uncertainty in their analysis. Conclusions This review brings together the cost-effectiveness literature for novel screening and testing methods used in the diagnosis of prostate cancer. Several limitations of the published models were identified. The models generally either compared new biomarkers or new imaging techniques which highlights the importance of future work in this area, as biomarkers and imaging are likely to be used in combination.

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Section: Patient Populationmentioning

confidence: 99%

Section: Treatment Typesmentioning

confidence: 99%

Section: Quality Of Lifementioning

confidence: 99%

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Systematic Review of cost-effectiveness models in prostate cancer: exploring new developments in testing and diagnosis

Keeney

Thom

Turner

et al. 2020

Preprint

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“…The current standard of performing TRUS‐guided systematic biopsy in men with a PSA of 4–10 ng/mL results in a considerable number of unnecessary prostate biopsies and overtreatment of clinically indolent disease, both of which are costly from the patient and healthcare system perspectives . Two recent studies document that incorporating multiparametric (mp)MRI into prostate cancer screening has the potential to reduce overdiagnosis and overtreatment.…”

mentioning

confidence: 99%

“…In the current issue of BJUI , Barnett et al. evaluated the cost‐effectiveness of prostate MRI in a screening setting in order to determine whether MRI may be able to mitigate prostate biopsies in biopsy‐naïve men with a negative imaging study. They found that, when using the generally accepted threshold of $100 000/quality‐adjusted life year (QALY), the most cost‐efficient strategy consisted of obtaining prostate MRI in men with PSA >4 mg/mL.…”

mentioning

confidence: 99%

Multiparametric magnetic resonance imaging (MRI) with targeted fusion biopsy: is the time now?

Laviana

Penson²

2018

BJU International

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Comparison of Multiparametric Magnetic Resonance Imaging and Targeted Biopsy With Systematic Biopsy Alone for the Diagnosis of Prostate Cancer

et al. 2019

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Key Points Question Is prebiopsy magnetic resonance imaging combined with targeted biopsy associated with improved detection of clinically significant prostate cancer compared with transrectal ultrasonography–guided systematic prostate biopsy alone? Findings This systematic review and meta-analysis of 7 randomized clinical trials (2582 patients) demonstrates that prebiopsy magnetic resonance imaging combined with targeted biopsy is associated with improved detection of clinically significant prostate cancer and reduced numbers of biopsy cores per procedure, while potentially avoiding unnecessary biopsies. Meaning These findings support the introduction of prebiopsy magnetic resonance imaging into the diagnostic pathway for biopsy-naive men with suspected prostate cancer.

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Cost‐effectiveness of magnetic resonance imaging and targeted fusion biopsy for early detection of prostate cancer

Abstract: Our analysis suggests MRI followed by targeted MRI/ultrasonography fusion biopsy can be a cost-effective approach to the early detection of PCa.

Cited by 52 publications

References 40 publications

Systematic Review of cost-effectiveness models in prostate cancer: exploring new developments in testing and diagnosis

Systematic Review of cost-effectiveness models in prostate cancer: exploring new developments in testing and diagnosis

Multiparametric magnetic resonance imaging (MRI) with targeted fusion biopsy: is the time now?

Comparison of Multiparametric Magnetic Resonance Imaging and Targeted Biopsy With Systematic Biopsy Alone for the Diagnosis of Prostate Cancer

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