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MRI-targeted biopsy versus standard transrectal ultrasound-guided biopsy: a systematic review and meta-analysis of randomized controlled trials

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Abstract

Purpose

For men with a suspicion of prostate cancer (PCa), the transrectal ultrasound-guided biopsy (TRUS-Bx) was recommended. Multi-parametric magnetic resonance imaging (mp-MRI) could be more useful to more accurately selected patients who are with a clinical suspicion of PCa and eligible for biopsy, and avoid a biopsy if the result was negative. In the present study, we compared the MRI-targeted biopsy (MRI-TBx) with TRUS-Bx.

Methods

We searched the following online database: PubMed, Embase, and Cochrane Library, and the search was updated to March 2019.

Results

Finally, a total of 8 randomized controlled trials (RCTs) comprising 2593 patients were enrolled in the final analysis. MRI-TBx and TRUS-Bx did not significantly differ in overall PCa (RR = 1.30; 95% CI 0.98–1.72; P = 0.067), clinically significant PCa (RR = 1.35; 95% CI 0.98–1.86; P = 0.065), and clinically insignificant PCa (RR = 0.76; 95% CI 0.40–1.46; P = 0.416). While in patients with initial biopsy, MRI-TBx had a significantly higher detection rate of overall PCa (RR = 1.40; 95% CI 1.01–1.94; P = 0.045).

Conclusion

In the present study, we found that MRI-TBx potentially benefits the detection of overall and clinically significant PCa compared with TRUS-Bx in patients with a suspicion of PCa. Furthermore, in patients with initial biopsy, MRI-TBx had a significantly higher detection rate of overall PCa and a potentially higher detection rate of clinically significant PCa. While for patients with prior negative biopsy, we did not detect significant differences in overall and clinically significant PCa between two groups. More large and multicenter RCTs are further required.

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Author notes

  1. Xu Hu, Zhi-Qiang Yang and Yan-Xiang Shao have contributed equally to this article.

Authors and Affiliations

  1. West China School of Medicine/West China Hospital, Sichuan University, Chengdu, 610041, People’s Republic of China

    Xu Hu, Zhi-Qiang Yang, Yan-Xiang Shao, Wei-Chao Dou, San-Chao Xiong & Wei-Xiao Yang

  2. Department of Urology, West China Medical School, West China Hospital, Sichuan University, 37 Guoxue Street, Chengdu, 610041, People’s Republic of China

    Xiang Li

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  1. Xu Hu
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Hu, X., Yang, ZQ., Shao, YX. et al. MRI-targeted biopsy versus standard transrectal ultrasound-guided biopsy: a systematic review and meta-analysis of randomized controlled trials. Abdom Radiol 45, 3283–3292 (2020). https://doi.org/10.1007/s00261-019-02370-z

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