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Positive pre-biopsy MRI : are systematic biopsies still useful in addition to targeted biopsies?

(2019) WORLD JOURNAL OF UROLOGY. 37(2). p.243-251
Author
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Abstract
Purpose: The diagnostic strategy implementing multiparametric magnet resonance tomography (mpMRI) and targeted biopsies (TB) improves the detection and characterization of significant prostate cancer (PCa). We aimed to assess the clinical usefulness of systematic biopsies (SB) in the setting of patients having a pre-biopsy positive MRI. Methods: A review of the literature was performed in March 2018. All studies investigating the performance of SB in addition to TB (all techniques) were assessed, both in the biopsy-naive and repeat biopsy setting. Results: Evidence demonstrates that TB improves the detection of index-significant PCa compared with SB alone, in both initial and repeat biopsy settings. However, the combination of both TB and SB improved the overall (around 30%) and significant (around 10%) PCa detection rates as compared with TB alone. Significant differences between both biopsy approaches exist regarding cancer location favoring SB for the far lateral sampling, and TB for the anterior zone. Main current pitfalls of pure TB strategy are the learning curve and experience required for mpMRI reading and biopsy targeting, as well as the precision assessment in TB techniques. Conclusion: A pure TB strategy omitting SB leads to the risk of missing up to 15% of significant cancer, due to limitations of mpMRI performance/reading and of precision during lesion targeting. SB remain necessary, in addition to the TB, to obtain the most accurate assessment of the entire prostate gland in this sub-group of patients at risk of significant disease.
Keywords
Prostate cancer, Detection, Biopsy, Fusion, Targeted, Magnetic resonance imaging, SIGNIFICANT PROSTATE-CANCER, ULTRASOUND FUSION BIOPSY, MAGNETIC-RESONANCE, GUIDED BIOPSY, DIAGNOSTIC-ACCURACY, IN-BORE, STANDARD, ANTIGEN, TRIAL, MEN

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MLA
Ploussard, Guillaume et al. “Positive Pre-biopsy MRI : Are Systematic Biopsies Still Useful in Addition to Targeted Biopsies?” WORLD JOURNAL OF UROLOGY 37.2 (2019): 243–251. Print.
APA
Ploussard, G., Borgmann, H., Briganti, A., De Visschere, P., Fütterer, J. J., Gandaglia, G., Heidegger, I., et al. (2019). Positive pre-biopsy MRI : are systematic biopsies still useful in addition to targeted biopsies? WORLD JOURNAL OF UROLOGY, 37(2), 243–251.
Chicago author-date
Ploussard, Guillaume, Hendrik Borgmann, Alberto Briganti, Pieter De Visschere, Jurgen J Fütterer, Giorgio Gandaglia, Isabel Heidegger, et al. 2019. “Positive Pre-biopsy MRI : Are Systematic Biopsies Still Useful in Addition to Targeted Biopsies?” World Journal of Urology 37 (2): 243–251.
Chicago author-date (all authors)
Ploussard, Guillaume, Hendrik Borgmann, Alberto Briganti, Pieter De Visschere, Jurgen J Fütterer, Giorgio Gandaglia, Isabel Heidegger, Alexander Kretschmer, Romain Mathieu, Piet Ost, Prasanna Sooriakumaran, Cristian Surcel, Derya Tilki, Igor Tsaur, Massimo Valerio, and Roderick van den Bergh. 2019. “Positive Pre-biopsy MRI : Are Systematic Biopsies Still Useful in Addition to Targeted Biopsies?” World Journal of Urology 37 (2): 243–251.
Vancouver
1.
Ploussard G, Borgmann H, Briganti A, De Visschere P, Fütterer JJ, Gandaglia G, et al. Positive pre-biopsy MRI : are systematic biopsies still useful in addition to targeted biopsies? WORLD JOURNAL OF UROLOGY. 2019;37(2):243–51.
IEEE
[1]
G. Ploussard et al., “Positive pre-biopsy MRI : are systematic biopsies still useful in addition to targeted biopsies?,” WORLD JOURNAL OF UROLOGY, vol. 37, no. 2, pp. 243–251, 2019.
@article{8617725,
  abstract     = {Purpose: The diagnostic strategy implementing multiparametric magnet resonance tomography (mpMRI) and targeted biopsies (TB) improves the detection and characterization of significant prostate cancer (PCa). We aimed to assess the clinical usefulness of systematic biopsies (SB) in the setting of patients having a pre-biopsy positive MRI. 
Methods: A review of the literature was performed in March 2018. All studies investigating the performance of SB in addition to TB (all techniques) were assessed, both in the biopsy-naive and repeat biopsy setting. 
Results: Evidence demonstrates that TB improves the detection of index-significant PCa compared with SB alone, in both initial and repeat biopsy settings. However, the combination of both TB and SB improved the overall (around 30%) and significant (around 10%) PCa detection rates as compared with TB alone. Significant differences between both biopsy approaches exist regarding cancer location favoring SB for the far lateral sampling, and TB for the anterior zone. Main current pitfalls of pure TB strategy are the learning curve and experience required for mpMRI reading and biopsy targeting, as well as the precision assessment in TB techniques. 
Conclusion: A pure TB strategy omitting SB leads to the risk of missing up to 15% of significant cancer, due to limitations of mpMRI performance/reading and of precision during lesion targeting. SB remain necessary, in addition to the TB, to obtain the most accurate assessment of the entire prostate gland in this sub-group of patients at risk of significant disease.},
  author       = {Ploussard, Guillaume and Borgmann, Hendrik and Briganti, Alberto and De Visschere, Pieter and Fütterer, Jurgen J and Gandaglia, Giorgio and Heidegger, Isabel and Kretschmer, Alexander and Mathieu, Romain and Ost, Piet and Sooriakumaran, Prasanna and Surcel, Cristian and Tilki, Derya and Tsaur, Igor and Valerio, Massimo and van den Bergh, Roderick},
  issn         = {0724-4983},
  journal      = {WORLD JOURNAL OF UROLOGY},
  keywords     = {Prostate cancer,Detection,Biopsy,Fusion,Targeted,Magnetic resonance imaging,SIGNIFICANT PROSTATE-CANCER,ULTRASOUND FUSION BIOPSY,MAGNETIC-RESONANCE,GUIDED BIOPSY,DIAGNOSTIC-ACCURACY,IN-BORE,STANDARD,ANTIGEN,TRIAL,MEN},
  language     = {eng},
  number       = {2},
  pages        = {243--251},
  title        = {Positive pre-biopsy MRI : are systematic biopsies still useful in addition to targeted biopsies?},
  url          = {http://dx.doi.org/10.1007/s00345-018-2399-z},
  volume       = {37},
  year         = {2019},
}

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