Takeaway
- Meta-analysis suggests that in individuals with suspected prostate cancer, magnetic resonance imaging-targeted biopsy (MRI-TB) vs systematic biopsy:
- Increases clinically significant cancer detection rate by 16%,
- Avoids biopsies in 34% of individuals with clinically insignificant cancer, and
- Requires fewer biopsy cores.
Why this matters
- MRI-TB strategy can identify individuals who will benefit from treatment, avoid unnecessary biopsy, and overtreatment in low-risk disease.
Study design
- Meta-analysis of 76 studies (including 8 randomized studies) and 14,709 individuals with suspected prostate cancer, identified after a search on PubMed, Embase, Web of Science, Cochrane library, and Clinicaltrials.gov databases.
- Funding: United Kingdom National Institute for Health Research.
Key results
- MRI-TB detected a higher number of patients with clinically significant cancer vs systematic biopsy (56 studies; detection ratio [DR], 1.16; P<.0001 and fewer with clinically insignificant cancer studies dr p>
- The proportion of cores positive for cancer was significantly higher with MRI-TB vs systematic biopsy (18 studies; 31% vs 11%; relative risk, 3.17; P<.0001>
- No difference was observed in any cancer detection (DR, 1.02; P=.49).
Limitations
- Publication bias.
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