MP24-18 SYSTEMATIC REVIEW AND META-ANALYSIS OF SIGNIFICANT CANCER DETECTION BY MRI-TARGETED BIOPSY COMPARED TO SYSTEMATIC BIOPSY

Abstract

You have accessJournal of UrologyProstate Cancer: Detection & Screening III (MP24)1 Apr 2019MP24-18 SYSTEMATIC REVIEW AND META-ANALYSIS OF SIGNIFICANT CANCER DETECTION BY MRI-TARGETED BIOPSY COMPARED TO SYSTEMATIC BIOPSY Veeru Kasivisvanathan*, Armando Stabile, Joana Neves, Francesco Giganti, Massimo Valerio, Yaalini Shanmugabavan, Keiran Clement, Debashis Sarkar, Yiannis Philippou, David Thurtle, Jon Deeks, Mark Emberton, Yemisi Takwoingi, and Caroline Moore Veeru Kasivisvanathan*Veeru Kasivisvanathan* More articles by this author , Armando StabileArmando Stabile More articles by this author , Joana NevesJoana Neves More articles by this author , Francesco GigantiFrancesco Giganti More articles by this author , Massimo ValerioMassimo Valerio More articles by this author , Yaalini ShanmugabavanYaalini Shanmugabavan More articles by this author , Keiran ClementKeiran Clement More articles by this author , Debashis SarkarDebashis Sarkar More articles by this author , Yiannis PhilippouYiannis Philippou More articles by this author , David ThurtleDavid Thurtle More articles by this author , Jon DeeksJon Deeks More articles by this author , Mark EmbertonMark Emberton More articles by this author , Yemisi TakwoingiYemisi Takwoingi More articles by this author , and Caroline MooreCaroline Moore More articles by this author View All Author Informationhttps://doi.org/10.1097/01.JU.0000555643.29067.edAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: MRI-targeted biopsy (MRI-TB) is a diagnostic test strategy that serves as an alternative to systematic prostate biopsy. This systematic review aimed to assess the detection rates of clinically significant (CSC) and clinically insignificant cancer (CIC) by MRI-targeted biopsy compared to systematic biopsy in men with suspected prostate cancer. METHODS: A literature search was carried out using Embase, PubMed, Web of Science, Cochrane library and Clinicaltrials.gov databases using search terms including: “biopsy”, “MRI” and “prostate” and variations of these. For inclusion, each paper needed to specify cancer detection rates from the biopsies taken only from MRI suspicious areas. Systematic biopsy included 10 to 12 core ultrasound guided transrectal (TRUS) or transperineal template mapping (TPM) biopsy. The methodological quality of included studies was assessed using a modified QUADAS-2 checklist. CSC was defined as Gleason score 3+4 or greater and CIC as Gleason score 3+3, unless otherwise specified by the study. A detection ratio (DR) was calculated as the proportion of men with the target condition in the MRI-TB arm divided by the proportion in the systematic biopsy arm. A DR > 1 indicated that MRI-TB detected the target condition more frequently than systematic biopsy. For each target condition, DRs were pooled using random effects meta-analysis. Differences between subgroups were formally assessed with univariate meta-regression. RESULTS: More than 7000 studies were screened. For CSC detection, 73 studies (5906 patients) were included. MRI-TB had a higher detection rate for CSC than systematic biopsy (DR, 1.12 [95% CI 1.07-1.18], p <0.001), though meta-regression showed that this depended on the type of systematic biopsy (p = 0.053), with MRI-TB performing slightly better compared to TRUS biopsy than compared to TPM biopsy. MRI-TB had higher detection rates irrespective of prior biopsy status (p = 0.91) and type of MRI (cognitive versus fusion biopsy, p = 0.70). Of the 73 studies, 61 studies (2917 patients) were included for CIC detection. MRI-TB had a lower detection rate of CIC than systematic biopsy (DR, 0.66 [95% CI 0.59-0.74], p <0.001). The methodological quality of the included studies was moderate. CONCLUSIONS: This study provides evidence supporting the use of MRI-TB over TRUS biopsy as a diagnostic test for men with suspected prostate cancer Source of Funding: National Institute for Health Research UK London, United Kingdom; Lausanne, Switzerland; London, United Kingdom; Glasgow, United Kingdom; Winchester, United Kingdom; Oxford, United Kingdom; Cambridge, United Kingdom; Birmingham, United Kingdom; London, United Kingdom; Birmingham, United Kingdom; London, United Kingdom© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e341-e341 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information Veeru Kasivisvanathan* More articles by this author Armando Stabile More articles by this author Joana Neves More articles by this author Francesco Giganti More articles by this author Massimo Valerio More articles by this author Yaalini Shanmugabavan More articles by this author Keiran Clement More articles by this author Debashis Sarkar More articles by this author Yiannis Philippou More articles by this author David Thurtle More articles by this author Jon Deeks More articles by this author Mark Emberton More articles by this author Yemisi Takwoingi More articles by this author Caroline Moore More articles by this author Expand All Advertisement PDF downloadLoading ...

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