Magnetic Resonance Imaging Targeted Biopsy Improves Selection of Patients Considered for Active Surveillance for Clinically Low Risk Prostate Cancer Based on Systematic Biopsies

Ouzzane, A.; Renard-Penna, Raphaële; Marlière, F.; Mozer, Pierre; Olivier, Jonathan; Barkatz, Johann; Puech, Philippe; Villers, Arnauld

doi:10.1016/j.juro.2015.02.2938

Cited by 70 publications

(48 citation statements)

References 30 publications

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“…In recent years, mpMRI and mpMRI/TRUS fusion targeted biopsy have a good degree of accuracy in diagnosing clinically significant PCa secondary to the high sensitivity for lesion upgrading [8][9][10][11], especially when the cancer is located in the anterior prostate [6,7] or in the presence of micro-focal PCa (1 positive core of GS and GPC ≤ 5 %) [21]. Ouzzane et al [24] reporting on 281 patients in AS found that mpMRI targeted biopsy reclassified 10 % of patients who were eligible for AS based on systematic biopsy. Kamrava et al [25] in a series of 245 patients with a diagnosis of low-risk PCa enrolled in an AS protocol reported that at confirmation biopsy 24 % were upgraded using MRI fusion biopsy versus 14 % using standard transrectal biopsy, respectively.…”

Section: Discussionmentioning

confidence: 99%

Can MRI/TRUS fusion targeted biopsy replace saturation prostate biopsy in the re-evaluation of men in active surveillance?

et al. 2015

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Section: Discussionmentioning

confidence: 99%

Can MRI/TRUS fusion targeted biopsy replace saturation prostate biopsy in the re-evaluation of men in active surveillance?

et al. 2015

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“…Even more recently the combination of MRI/Ultrasound (MRI/US) guided platforms provides the ability to overlay MP-MRI images in real time on TRUS, and thus perform more targeted biopsies. This targeting allows for the diagnosis of more high-risk cases and fewer low-risk cases of prostate cancer in comparison to standard sextant biopsy [6,7], as well as track lesions over time with imaging or repeat biopsy, through active surveillance (AS) [8,9]. Targeted MRI/US guided biopsy is an emerging technology that has the potential to change standard of care for the diagnosis and management of prostate cancer.…”

Section: Introductionmentioning

confidence: 99%

National Survey of Patterns Employing Targeted MRI/US Guided Prostate Biopsy in the Diagnosis and Staging of Prostate Cancer

et al. 2019

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Background/aims: Targeted magnetic resonance imaging/ ultrasound (MRI/US) guided biopsy is an emerging technology that has the potential to change standard of care for the diagnosis and management of prostate cancer. This technology is rapidly proliferating, however quantitative analysis of these trends are unavailable. The objective of this study was to assess urologist opinions regarding implementing MRI/ US imaging into their practices. Methods: A questionnaire was distributed using research electronic data capture and completed by 291 practicing urologists within the United States registered through the American Urological Association. The survey gathered information regarding demographics, changes in MRI use, opinions on targeted MRI/US guided biopsy, and barriers to implementation. The survey results were analyzed using ANOVA. Results: Practice setting and geographic region were signifIcantly associated with implementation of MRI/US guided biopsy. Total 72% of urologists in academic centers report using MRI/US targeted biopsy, compared to 38% in solo private practice. In the northeast 68% of urologists report using MRI/US biopsy, compared to 44% in the western United States. Conclusion: While there are some reservations about employing MRI/US guided biopsy as standard of care in all prostate biopsies, the data suggests urologists support its use, and are making efforts to introduce targeted MRI/US guided biopsy into their practice. Regional and practice setting variations exist in implementation.

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“…Other data confirm this by showing a low relative sensitivity ratio of 0.33 for the detection of Gleason score ≥7 PCa in mpMRI compared to sysPbx [32]. In contrast, other study groups demonstrated that mpMRI and targeted biopsy mainly contributed to the Gleason score upgrading, whereas sysPbx did not lead to an upgrading [33]. In Table 4.…”

Section: Discussionmentioning

confidence: 79%

Evaluation of Magnetic Resonance Imaging/Ultrasound-Fusion Biopsy in Patients with Low-Risk Prostate Cancer Under Active Surveillance Undergoing Surveillance Biopsy

Borkowetz¹,

Renner²,

Platzek³

et al. 2018

Urol Int

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Introduction: Targeted biopsy of tumour-suspicious lesions detected in multiparametric magnetic resonance imaging (mpMRI) plays an increasing role in the active surveillance (AS) of patients with low-risk prostate cancer (PCa). The aim of this study was to compare MRI/ultrasound-fusion biopsy (fusPbx) with systematic biopsy (sysPbx) in patients undergoing biopsy for AS. Methods: Patients undergoing mpMRI and transperineal fusPbx combined with transrectal sysPbx (comPbx) as surveillance biopsy were investigated. The detection of Gleason score upgrading and reclassification according to Prostate Cancer Research International Active Surveillance criteria were evaluated. Results: Eighty-three patients were enrolled. PCa upgrading was detected in 39% by fusPbx and in 37% by sysPbx (p = 1.0). The percentage of patients who were reclassified in fusPbx and sysPbx (p = 0.45) were 64 and 59% respectively. ComPbx detected more frequently tumour upgrading than fusPbx (71 vs. 64%, p = 0.016) and sysPbx (71 vs. 59%, p < 0.001) and more patients had to be reclassified after comPbx than after fusPbx or sysPbx alone. Conclusions: The combination of fusPbx and sysPbx outperforms both modalities alone with regard to the detection of upgrading and reclassification in patients under AS. Because a high missing rate of significant PCa still exists in both biopsy modalities, a combination of fusPbx and sysPbx should be recommended in these patients.

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Magnetic Resonance Imaging Targeted Biopsy Improves Selection of Patients Considered for Active Surveillance for Clinically Low Risk Prostate Cancer Based on Systematic Biopsies

Abstract: Magnetic resonance imaging targeted biopsy reclassified 10% of patients who were eligible for active surveillance based on systematic biopsy. Its incorporation into the active surveillance eligibility criteria may decrease the risk of reclassification to higher stages during followup.

Cited by 70 publications

References 30 publications

Can MRI/TRUS fusion targeted biopsy replace saturation prostate biopsy in the re-evaluation of men in active surveillance?

Can MRI/TRUS fusion targeted biopsy replace saturation prostate biopsy in the re-evaluation of men in active surveillance?

National Survey of Patterns Employing Targeted MRI/US Guided Prostate Biopsy in the Diagnosis and Staging of Prostate Cancer

Evaluation of Magnetic Resonance Imaging/Ultrasound-Fusion Biopsy in Patients with Low-Risk Prostate Cancer Under Active Surveillance Undergoing Surveillance Biopsy

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