OverviewMultiparametric Magnetic Resonance Imaging in the Diagnosis of Clinically Significant Prostate Cancer: an Updated Systematic Review
Section snippets
Statement of Search Strategies Used and Sources of Information
The following sources were searched for existing systematic reviews, guidelines and primary literature, published from 2013 to September 2020, with search term(s) including prostate cancer, prostate carcinoma, clinically significant, clinically insignificant and magnetic resonance: National Guideline Clearinghouse, National Health and Medical Research Council, New Zealand Guidelines Group, American Society of Clinical Oncology, National Institute for Health and Clinical Excellence, Scottish
Literature Search
The following were searched for existing systematic reviews and guidelines published since 2016: the National Guideline Clearinghouse, National Health and Medical Research Council, New Zealand Guidelines Group, American Society of Clinical Oncology, National Institute for Health and Clinical Excellence, Scottish Intercollegiate Guidelines Network, MEDLINE, EMBASE and the Cochrane Database of Systematic Reviews. As no recent systematic reviews that fully met the study inclusion criteria (below)
Literature Search Results
There were no existing guidelines or systematic reviews that fully met the study criteria. Figure 1 shows the primary literature considered for inclusion. Of 9214 citations identified, 5460 duplicate articles were excluded. From the remaining 3754, 3555 were excluded at the abstract and title level and the remaining 199 were examined at the full-text level. Of these, 163 were excluded for various reasons. Thirty-six studies from 39 publications [[6], [7], [8], [9], [10], [11], [12],[22], [23],
Discussion
This report updates a previous systematic review evaluating MPMRI in the diagnosis of CSPCa. The current evidence summary includes 36 studies examining the research questions.
Based on the above evidence, MPMRI is beneficial for men who are biopsy naïve and men with a prior negative TRUS-SB at elevated risk of CSPCa (discordant PSA) as it increases the chance of identifying CSPCa. For the biopsy-naïve men, MPMRI also decreases the need for unnecessary biopsies, whereas for men with a discordant
Conclusions
The growing acceptance of MPMRI utilisation internationally and the recent publication of several RCTs regarding MPMRI in reducing CISPCa detection rates, particularly in biopsy-naïve men, without loss of sensitivity for CSPCa necessitates the synthesis of updated evidence examining MPMRI in the diagnosis of CSPCa.
Conflicts of interest
The authors declare no conflicts of interest.
Acknowledgements
The authors would like to thank members from the MPMRI in the diagnosis of clinically significant prostate cancer Guideline Development Group in Ontario (P. Aprikian, G. Bauman, R. Breau, S. Chang, J. Dobranowski, S. Ghai, L. Klotz, S. Morgan, B. Shayegan) for their comments on the early draft of this project.
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