Multicentre evaluation of magnetic resonance imaging supported transperineal prostate biopsy in biopsy‐naïve men with suspicion of prostate cancer

Abstract

MRI-based transperineal biopsy performed at high-volume tertiary care centres with a significant experience of prostate mpMRI and image-guided targeted biopsies yielded high detection rates of Gleason score 7-10 cancer. Prostate biopsies may not be needed for men with low PSAD and an unsuspicious MRI. In patients with high probability lesions, combined targeted and systematic biopsies are recommended.

MRI-Targeted or Standard Biopsy for Prostate-Cancer Diagnosis

“…From all the reports and published literature to date the TVT would appear to be as, if not more, effective than all other procedures without having a higher complication rate. The data in the present paper by Braga et al [1] should reassure healthcare providers that TVT continues to be a safe and effective surgical strategy for the management of SUI in women.…”

“…undertaken. In the present study from Italy and Switzerland, however, Braga et al have managed to follow up 46 out of 52 (88.4%) women who had a traditional TVT inserted between 1998 and 2000 [1]. The remaining patients were lost to follow-up or had died in the intervening period.…”

“…The paper published in this issue of the BJUI titled 'Multicentre evaluation of magnetic resonance imaging supported transperineal biopsy in biopsy-na€ ıve men with suspicion of prostate cancer' is timely and helps to resolve some of the uncertainty inherent within the diagnostic pathway [1]. [3].…”

Avoiding biopsy in men with PI‐RADS scores 1 and 2 on multiparametric MRI of the prostate, ready for prime time?

“…This is also supported by a multicentre study by Hansen et al. , which demonstrated that the NPV of a negative mpMRI for excluding Gleason 7–10 cancer was 80%, but improved to 91% with a PSA density of <0.1 ng/mL/mL, and to 89% with a PSA density of <0.15 ng/mL/mL. It is important to note that these studies used transperineal biopsies rather than 12‐core transrectal biopsies, suggesting the latter to be a more unreliable reference test with a greater probability of missing clinically significant cancer on systematic sampling.…”

National implementation of multi‐parametric magnetic resonance imaging for prostate cancer detection – recommendations from a UK consensus meeting

“…It was agreed but not in consensus that biopsy options in equivocal mpMRI should include MR‐guided biopsy (visually estimated, image fusion or in‐bore; eight of 12 panelists), transperineal systematic biopsy (seven of 12 panelists) or combined targeted and systematic sampling (seven of 12 panelists) of the gland. Emerging evidence shows no statistical difference between the use of combined targeted and systematic biopsy vs each biopsy technique alone for significant cancer detection in equivocal lesions .…”