“…Although previous studies have shown that MRI-directed TBx is a promising biopsy strategy [22] , [23] , there are still substantial differences in GG ≥2 PCa detection when compared to saturation template biopsy [13] , [24] , [25] , [26] , [27] . Additionally found cancers are often in sextants adjacent to MRI-positive lesions, while systematic sampling of normal-appearing nonadjacent sectors does not alter risk stratification in the majority of cases.…”
Section: Discussionmentioning
confidence: 99%
“… Fig. 2 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram showing the search outcome and selection of full studies included in the review [3] , [9] , [10] , [11] , [12] , [13] , [18] , [19] and the studies excluded [38] , [39] , [40] . …”
Section: Evidence Acquisitionmentioning
confidence: 99%
“…); an agreement rate of 78% was observed between the reviewers. Ultimately, eight studies were eligible for inclusion: three prospective cohort studies [9] , [11] , [18] and five retrospective cohort studies [3] , [10] , [12] , [13] , [19] . All the studies included investigated the performance of their proposed TBx + RBx approach relative to both TBx + SBx and TBx alone.…”
Section: Evidence Synthesismentioning
confidence: 99%
“…Use of such an MRI-directed TBx + RBx approach yields equivalent detection rates for significant PCa in comparison to the recommended MRI-directed TBx + SBx approach and reduces the number of biopsy cores and overdiagnosis rates [9] , [10] , [11] , [12] . Currently, there is no consensus on such an MRI-directed TBx + RBx approach and several definitions can be found in the literature, including focal saturation biopsy , perilesional biopsy , regional targeted biopsy , and targeted sector biopsy [3] , [11] , [12] , [13] . Although different interpretations exist, the scope of these interpretations is broadly in line: limit SBx to the proximity of the MRI-positive lesion.…”
“…Although previous studies have shown that MRI-directed TBx is a promising biopsy strategy [22] , [23] , there are still substantial differences in GG ≥2 PCa detection when compared to saturation template biopsy [13] , [24] , [25] , [26] , [27] . Additionally found cancers are often in sextants adjacent to MRI-positive lesions, while systematic sampling of normal-appearing nonadjacent sectors does not alter risk stratification in the majority of cases.…”
Section: Discussionmentioning
confidence: 99%
“… Fig. 2 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram showing the search outcome and selection of full studies included in the review [3] , [9] , [10] , [11] , [12] , [13] , [18] , [19] and the studies excluded [38] , [39] , [40] . …”
Section: Evidence Acquisitionmentioning
confidence: 99%
“…); an agreement rate of 78% was observed between the reviewers. Ultimately, eight studies were eligible for inclusion: three prospective cohort studies [9] , [11] , [18] and five retrospective cohort studies [3] , [10] , [12] , [13] , [19] . All the studies included investigated the performance of their proposed TBx + RBx approach relative to both TBx + SBx and TBx alone.…”
Section: Evidence Synthesismentioning
confidence: 99%
“…Use of such an MRI-directed TBx + RBx approach yields equivalent detection rates for significant PCa in comparison to the recommended MRI-directed TBx + SBx approach and reduces the number of biopsy cores and overdiagnosis rates [9] , [10] , [11] , [12] . Currently, there is no consensus on such an MRI-directed TBx + RBx approach and several definitions can be found in the literature, including focal saturation biopsy , perilesional biopsy , regional targeted biopsy , and targeted sector biopsy [3] , [11] , [12] , [13] . Although different interpretations exist, the scope of these interpretations is broadly in line: limit SBx to the proximity of the MRI-positive lesion.…”
“…4,7,8 PSA density plays an important role in stratifying patients according to the need for biopsy by improving the negative predictive value (NPV) in negative mpMRI and allowing further characterization of MRI-suspicious lesions. 4,[8][9][10] However, ancillary imaging features that can suggest csPCa or benignity have been rarely investigated. In the Liver Imaging and Reporting Data System (LI-RADS), which adopted ancillary features to be used in combination with major features, the use of ancillary features improved sensitivity without compromising specificity by adjusting the categorization and allowing lesion characterization.…”
The relatively low specificity and positive predictive value of the Prostate Imaging‐Reporting and Data System (PI‐RADS) can lead to considerable false‐positive results and unnecessary biopsies. The aim of this study was to propose ancillary features (AFs) indicating clinically significant prostate cancer (csPCa) or benign tissues in PI‐RADS category ≥3 lesions and determine the usefulness of these AFs in reducing false‐positive assessments of suspicious lesions in men at csPCa risk. This was a retrospective study, which included 199 men. A 3T, including turbo spin echo T2‐weighted, echo‐planar diffusion‐weighted, and spoiled gradient echo dynamic contrast‐enhanced (DCE) images, was used. Five AFs (prostate‐specific antigen density ≥0.15 ng/mL2; size ≥10 mm; heterogeneous T2 signal intensity; circumscribed nodule in the junction of peripheral and transition zone; and DCE time curves) indicating csPCa or non‐csPCa were evaluated by three independent readers. The sensitivity and specificity of each AF were calculated. Inter‐reader agreement was evaluated using κ statistics. Univariate and multivariate logistic regression analyses were conducted to determine significant AFs. The reduction in positive call rates and csPCa detection rates with combined AF use were calculated and compared with the findings obtained with PI‐RADS use alone. The sensitivities and specificities of the AFs indicating csPCa were 72.1%–96.5% and 27.4%–75.2% for reader 1, 66.3%–96.5% and 23.9%–62.0% for reader 2, and 67.4%–96.5% and 34.5%–78.8% for reader 3, with moderate to substantial inter‐reader agreement (Fleiss κ, 0.551–0.643). The combined use of two or more AFs for assessing PI‐RADS ≥3 lesions resulted in a 19.6%–30.7% reduction in positive calls (p < .05) compared to PI‐RADS use alone while preserving the csPCa detection rates (p ≥ .06) for three readers. The use of AFs in combination with PI‐RADS can reduce positive calls and false positives without csPCa under‐detection.
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