Diagnostic Performance of a Magnetic Resonance Imaging-directed Targeted plus Regional Biopsy Approach in Prostate Cancer Diagnosis: A Systematic Review and Meta-analysis

An Magnetic Resonance Imaging–directed Targeted-plus-perilesional Biopsy Approach for Prostate Cancer Diagnosis: “Less Is More”

“…Given the lack of consensus on how to implement a TBx + perilesional SBx approach, different interpretations exist in the current literature, differing in both the suggested numbers and the locations of perilesional SBx [13] . Owing to the high level of skill and expertise required for previously proposed templates, applicability has been limited so far.…”

“…1 ). Based on pre-existing literature, perilesional SBx cores were defined as all nontargeted biopsy cores taken from the ipsilateral prostate lobe sectors directly adjacent to the MRI-positive index lesion [13] .

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“…Ideally, prostate biopsy strategies maximize the detection of csPCa, while minimizing the detection of ciPCa. Considering that most men benefit diagnostically from increased sampling of index lesions, limiting SBx to the region around the index lesion could potentially effectuate this [13] , [14] . This study aims to retrospectively evaluate the diagnostic performance of TBx + perilesional SBx, compared with TBx + standard SBx, in men with MRI-positive unilateral lesion(s) suggestive of being csPCa.…”

Magnetic Resonance Imaging–targeted Prostate Biopsy Compared with Systematic Prostate Biopsy in Biopsy-naïve Patients with Suspected Prostate Cancer

“…They show that perilesional biopsies, taken from a band of 10 mm outside the MRI lesions, can detect up to 26% more cases of csPCa that are not present within the lesion. In addition to perilesional targeted biopsies, regional systematic biopsies are being investigated [15] . In our cohort, systematic biopsies detected csPCa in 23 cases of negative MRI-TBx (four non-csPCa and 19 no PCa), suggesting MRI-TBx failure.…”

Towards a judicious use of perilesional biopsy in the era of MRI-targeting, parting of the ways from systematic prostate biopsy

“…For smaller lesions, the PI-RADS committee proposed the use of focal saturation biopsies or regional target biopsies (RTB) [7]. A recent systemic analysis showed that RTB yields for detecting GG ≥ 2 cancers are not different to combined targeted and systematic biopsies, with the benefits of using fewer biopsy cores [8]. As in the studies of Deniffel and Adhoot, the MRI-directed RTB approach was superior to targeted biopsies alone for detecting GG ≥ 2 cancers (p < 0.001).…”