MRI-Guided Biopsy for Prostate Cancer Detection: A Systematic Review of Current Clinical Results
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PROSTATE CANCER (D PAREKH, SECTION EDITOR)
MRI-Guided Biopsy for Prostate Cancer Detection: A Systematic Review of Current Clinical Results Christiaan G. Overduin & Jurgen J. Fütterer & Jelle O. Barentsz
Published online: 9 April 2013 # Springer Science+Business Media New York 2013
Abstract In-bore magnetic resonance-guided biopsy (MRGB) has been increasingly used in clinical practice to detect prostate cancer (PCa). This review summarizes the current clinical results of this biopsy method. A systematic literature search was performed in the PubMed and Embase databases. Of 2,035 identified records, 49 required full review. In all, ten unique studies reporting clinical results of MRGB could be included. Reported PCa detection rates ranged from 8 to 59 % (median 42 %). The majority of tumors detected by MRGB were clinically significant (81–93 %). Most frequent complications of MRGB are transient hematuria (1–24 %) and short-term perirectal bleeding (11–17 %). Major complications are rare. Based on the reviewed literature, MRGB can be regarded an accurate and safe diagnostic tool to detect clinically significant PCa. However, as general availability is limited, this procedure should be reserved for specific patients. Appropriate indications will have to be determined. Keywords MRI . Image-guided biopsy . Prostate cancer . Transient hematuria . Short-term perirectal bleeding
Introduction Prostate cancer (PCa) continues to be a major health problem in developed countries, accounting for an estimated C. G. Overduin : J. J. Fütterer : J. O. Barentsz (*) Department of Radiology, Radboud University Nijmegen Medical Centre, Geert Grooteplein Zuid 10, P.O. Box 9101 (766), 6500 HB, Nijmegen, the Netherlands e-mail: [email protected] C. G. Overduin e-mail: [email protected] J. J. Fütterer e-mail: [email protected]
29 % (240,890) of new cancer cases and 11 % (33,720) of cancers deaths in men in the United States in 2011 [1]. In the era of prostate specific antigen (PSA) screening tests, urologists are increasingly confronted with the dilemma of seeing patients with a high clinical suspicion of PCa but negative transrectal ultrasound (TRUS)-guided biopsy results. Additional biopsy sessions have no significant impact on cancer detection, leaving a large number of patients with diagnostic uncertainty [2–4]. Over the past years, the value of multi-parametric magnetic resonance imaging (MRI) in detecting PCa has been well established. Using this technique, high localization accuracy can be achieved (AUC 0.88–0.97) [5, 6]. Consequently, MR imaging has also been proposed in guiding biopsies towards cancer suspicious regions, with the aim of improving diagnostic performance of prostate biopsy. Initial case reports describing MR-guided biopsy (MRGB) for PCa detection appeared in 2000 [7, 8]. The first study on the clinical use of MRGB of the prostate in a patient cohort (n=12) originates from 2005, when Beyersdorff et al. reported the results of using a newly developed MR-compatible biopsy device in a transrectal approa
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