Multiparametric MRI/TRUS Fusion Prostate Biopsy: Advantages of a Transperineal Approach

Pepe, Pietro; Garufi, Antonio; Priolo, Gian Domenico; Pennisi, Michele

doi:10.21873/anticanres.11695

Cited by 15 publications

(9 citation statements)

References 25 publications

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“…We found 39 retrospective studies, 46 prospective studies, and 13 RCTs where periprocedural antibiotics were administered [12] , [13] , [14] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] , [59] , [60] , [61] , [62] , [63] , [64] , [65] , [67] , [68] , [70] , [71] , [72] , [73] , [74] , [75] , [76] , [77] , [78] , [79] , [80] , [81] , [82] , [83] , [84] , [85] , …”

Section: Evidence Synthesisunclassified

Role of Prophylactic Antibiotics in Transperineal Prostate Biopsy: A Systematic Review and Meta-analysis

Basourakos

Alshak

Lewicki

et al. 2022

European Urology Open Science

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Section: Evidence Synthesisunclassified

Role of Prophylactic Antibiotics in Transperineal Prostate Biopsy: A Systematic Review and Meta-analysis

Basourakos

Alshak

Lewicki

et al. 2022

European Urology Open Science

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“…The multiparametric MRI-ultrasound fusion biopsy is currently an accepted modality in the pathological detection of prostate cancer [30]. In contrast to prostate cancer, little effort has been made for developing the ‘MRI-PDD fusion TURBT’ for the diagnosis and treatment of bladder cancer.…”

Section: Discussionmentioning

confidence: 99%

A Potential Application of Dynamic Contrast-Enhanced Magnetic Resonance Imaging Combined with Photodynamic Diagnosis for the Detection of Bladder Carcinoma in Situ: Toward the Future ‘MRI-PDD Fusion TURBT’

et al. 2019

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The detection of carcinoma in situ (CIS) is essential for the management of high-risk non-muscle invasive bladder cancers. Here, we focused on dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) combined with photodynamic diagnosis (PDD) for the detection of CIS. A total of 45 patients undergoing pre-surgical DCE-MRI and PDD-assisted endoscopic surgery accompanied by biopsies of the eight segmentations were analyzed. Immunohistochemical analysis of the biopsies revealed hypervascularity of CIS lesions, a cause of strong submucosal contrast-enhancement. It was found that 56 (16.2%) of 344 biopsies had pathologically proven CIS. In the DCE-MRI, the overall sensitivity and specificity for detecting CIS were 48.2% and 81.9%, respectively. We set out two different combinations of PDD and DCE-MRI for detecting CIS. Combination 1 was positive when either the PDD or DCE-MRI were test-positive. Combination 2 was positive only when both PDD and DCE-MRI were test-positive. The overall sensitivity of combinations 1 and 2 were 75.0% and 37.5%, respectively (McNemar test, vs PDD alone; p = 0.041 and p < 0.001, respectively). However, the specificity was 74.0% and 91.7%, respectively (vs PDD alone; both p < 0.001). Our future goal is to establish ‘MRI-PDD fusion transurethral resction of the bladder tumor (TURBT), which could be an effective therapeutic and diagnostic approach in the clinical management of high-risk disease.

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“…48 -Seven studies reported on the diagnostic accuracy of mpMRI for previously negative patients with sensitivities of 78-100%, specificities of 30-100%, PPVs of 36-100%, and NPVs of 69-100%. 18,19,25,[27][28][29]37 -The overall improvement in csPCa detection rate for the 15 studies comparing mpMRI-TB alone to TRUS-SB was 5% (95% CI 3-7, p<0.0001), with a reduction of cisPCa detection of 7% (95% CI 4-9, p<0.00001). -The overall improvement in csPCa detection for the five cohort studies comparing mpMRI-TB plus TRUS-SB to mpMRI-TB alone was 5% (95% CI 2-8, p=0.0005).…”

Section: Key Evidence For Recommendationmentioning

confidence: 96%

“…Twenty-two trials (all full-text publications) compared mpMRI with a reference standard (n=7) or with TRUS-SB (n=15) for previously negative men. The certainty of the aggregate study evidence for each comparison showed 15 of the 22 studies to be at either low, 8,10,15,37 , moderate, 7,12,16,21,22,25 or unclear 17,19,[27][28][29] risk of bias based on a GRADE approach. 48 -Seven studies reported on the diagnostic accuracy of mpMRI for previously negative patients with sensitivities of 78-100%, specificities of 30-100%, PPVs of 36-100%, and NPVs of 69-100%.…”

Section: Key Evidence For Recommendationmentioning

confidence: 99%

Evidence-based guideline recommendations on multiparametric magnetic resonance imaging in the diagnosis of clinically significant prostate cancer: A Cancer Care Ontario updated clinical practice guideline

Brown

Haider²,

Chin³

et al. 2022

CUAJ

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Introduction: This clinical practice guideline is based on a systematic review to assess the use of multiparametric magnetic resonance imaging (mpMRI) in the diagnosis of clinically significant prostate cancer (csPCa) for biopsy-naive men and men with a prior negative transrectal ultrasound-guided systematic biopsy (TRUS-SB) at elevated risk. Methods: The methods of the clinical practice guideline included searches to September of 2020 of MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials. Internal and external reviews were conducted. Results: The recommendations are: Recommendation 1: For biopsy-naive patients at elevated risk of csPCa, mpMRI is recommended prior to biopsy in patients who are candidates for curative management with suspected clinically localized prostate cancer. - If the mpMRI is positive, mpMRI-targeted biopsy (TB) and TRUS-SB should be performed together to maximize detection of csPCa. - If the mpMRI is negative, consider forgoing any biopsy after discussion of the risks and benefits with the patient as part of shared decision-making and ongoing followup. Recommendation 2: In patients who had a prior negative TRUSSB and demonstrate a high risk of having csPCa in whom curative management is being considered: - mpMRI should be performed. - If the mpMRI is positive, targeted biopsy should be performed. Concomitant TRUS-SB can be considered depending on the patient’s risk profile and time since prior TRUS-SB biopsy. - If the mpMRI is negative, consider forgoing a TRUS-SB only after discussion of the risks and benefits with the patient as part of shared decision-making and ongoing followup. Recommendation 3: mpMRI should be performed and interpreted in compliance with the current Prostate Imaging Reporting & Data System (PI-RADS) guidelines.

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Multiparametric MRI/TRUS Fusion Prostate Biopsy: Advantages of a Transperineal Approach

Abstract: Multiparametric MRI/TRUS TP in comparison to TR fusion biopsy detected a greater percentage of small but clinically significant PCa of the anterior zone (86.7% vs. 46.7%; p=0.0001).

Cited by 15 publications

References 25 publications

Role of Prophylactic Antibiotics in Transperineal Prostate Biopsy: A Systematic Review and Meta-analysis

Role of Prophylactic Antibiotics in Transperineal Prostate Biopsy: A Systematic Review and Meta-analysis

A Potential Application of Dynamic Contrast-Enhanced Magnetic Resonance Imaging Combined with Photodynamic Diagnosis for the Detection of Bladder Carcinoma in Situ: Toward the Future ‘MRI-PDD Fusion TURBT’

Evidence-based guideline recommendations on multiparametric magnetic resonance imaging in the diagnosis of clinically significant prostate cancer: A Cancer Care Ontario updated clinical practice guideline

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