- Biopsy-naive men with suspected prostate cancer who underwent a multiparametric (mp) MRI-targeted biopsy with or without systematic biopsy had a significantly higher detection rate of any-grade, clinically meaningful, and high-grade cancer vs systematic biopsy alone.
- Performing only targeted biopsies lowered the rate of clinically insignificant cancer diagnosis, but not of clinically meaningful or high-grade cancer.
Why this matters
- Recent guidelines recommend performing mpMRI in biopsy-naive men with suspected prostate cancer, but these recommendations are not widely used.
- Meta-analysis of 29 studies including 13,845 biopsy-naive men with suspected prostate cancer.
- 5 randomized clinical trials, 14 prospective cohort studies, and 10 retrospective studies were included.
- Funding: UK National Institute for Health Research.
- Compared with systematic biopsy, use of mpMRI-targeted biopsy was associated with:
- 15% higher rate of any prostate cancer diagnosis (P<.00001>
- 11% higher rate of clinically significant prostate cancer in 5 randomized trials (P=.05) and 18% higher in 9 prospective cohort studies (P<.00001>
- 2% higher rate of high-grade cancer (P=.005).
- No difference in diagnosis of clinically insignificant prostate cancer (risk difference, 0; P=.96).
- The mpMRI informed biopsy procedure was not standardized.