ArticleThe Journal of urology2017
Missing the Mark: Prostate Cancer Upgrading by Systematic Biopsy over Magnetic Resonance Imaging/Transrectal Ultrasound Fusion Biopsy.
Article in The Journal of urology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
50 citing papers in PubMed, 1 synthesis or guideline pooled it, 98 citations in OpenAlex.
- Prostate Imaging-Reporting and Data System Steering Committee: PI-RADS v2 Status Update and Future Directions.European urology · 2019Guideline
- Spatial Distribution of Prostate Cancer Missed by MRI-Targeted Biopsy, Effect of a Perilesional Template, and Restaging in a Radical Prostatectomy Cohort.The Prostate · 2026Article
- MR Imaging/Ultrasound Fusion-Guided Biopsy and Primary Focal Therapy for Localized Prostate Cancer.Magnetic resonance in medical sciences : MRMS : an official journal of Japan Society of Magnetic Resonance in Medicine · 2026Review
- PRE-POET: a qualitative interview-based study to explore patient-relevant factors in the context of prostate biopsy.BMC urology · 2025Article
- Enhancing Prostate Cancer Detection Accuracy in Magnetic Resonance Imaging-targeted Prostate Biopsy: Optimizing the Number of Cores Taken.European urology open science · 2024Review
- The distinct roles of reinforcement learning between pre-procedure and intra-procedure planning for prostate biopsy.International journal of computer assisted radiology and surgery · 2024Article
- Development and validation of a predictive model based on clinical and MpMRI findings to reduce additional systematic prostate biopsy.Insights into imaging · 2024Article
- Intensive sampling of the umbra and penumbra improves clinically significant prostate cancer detection and reduces risk of grade group upgrading at radical prostatectomy.World journal of urology · 2023Article
- A comprehensive comparison between mpMRI of the prostate, MR-US fusion biopsy and whole mount histopathology.World journal of urology · 2023Article
- Learning Curve of Transperineal MRI/US Fusion Prostate Biopsy: 4-Year Experience.Life (Basel, Switzerland) · 2023Article
- Individualized Decision Making in Transperineal Prostate Biopsy: Should All Men Undergo an Additional Systematic Biopsy?Cancers · 2022Article
- Pathological Accuracy in Prostate Cancer: Single-Center Outcomes of 3 Different Magnetic Resonance Imaging-Targeted Biopsy Techniques and Random Systematic Biopsy.Turkish journal of urology · 2022Article
- Paradigm Shift in Prostate Cancer Diagnosis: Pre-Biopsy Prostate Magnetic Resonance Imaging and Targeted Biopsy.Korean journal of radiology · 2022Review
- Application of Shear Wave Elastography and Contrast-Enhanced Ultrasound in Transrectal Prostate Biopsy.Current medical science · 2022Article
- A prospective study on inter-operator variability in semi-robotic software-based MRI/TRUS-fusion targeted prostate biopsies.World journal of urology · 2022Article
- Why Does Magnetic Resonance Imaging-Targeted Biopsy Miss Clinically Significant Cancer?The Journal of urology · 2022Article
- Article
- Results from a PI-RADS-based MRI-directed diagnostic pathway for biopsy-naive patients in a non-university hospital.Abdominal radiology (New York) · 2021Article
- Quantitative ultrasound shear wave elastography (USWE)-measured tissue stiffness correlates with PIRADS scoring of MRI and Gleason score on whole-mount histopathology of prostate cancer: implications for ultrasound image-guided targeting approach.Insights into imaging · 2021Article
- Yield of concurrent systemic biopsy during MRI-targeted biopsy according to Prostate Imaging Reporting and Data System version 2 in patients with suspected prostate cancer.European radiology · 2021Article
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Authors and funding
11 authors at 4 institutions in 1 country.
Funding
Abstract
purposeMultiparametric magnetic resonance imaging and fusion biopsy detect more high risk prostate cancer and less low risk prostate cancer than systematic biopsy. However, there remains a small subset of patients in whom systematic biopsy captures higher grade disease than fusion biopsy. We sought to identify potential mechanisms of the failure of fusion biopsy in the detection of clinically significant prostate cancer. MATERIALS AND
methodsWe reviewed a prospectively maintained database of patients who underwent multiparametric magnetic resonance imaging followed by fusion biopsy and systematic biopsy from 2007 to 2014. In patients in whom disease was upgraded to clinically significant disease (Gleason 7 or greater) by systematic biopsy over fusion biopsy, independent re-review of magnetic resonance imaging, archived biopsy imaging and whole mount pathology as well as needle coordinate mapping were performed. Multivariate logistic regression analysis was done to determine predictors of upgrading by systematic biopsy.
resultsDisease was upgraded based on systematic biopsy over fusion biopsy in 135 of 1,003 patients (13.5%), of whom only 62 (6.2%) were upgraded to intermediate (Gleason 7) and high risk (Gleason 8 or greater) prostate cancer (51 or 5.1% and 11 or 1.1%, respectively). On multivariate analysis lower prostate specific antigen (p <0.001), higher magnetic resonance imaging prostate volume (p <0.001) and a lower number of target cores (p = 0.001) were predictors of upgrading by systematic biopsy. Main mechanisms of under grading by fusion biopsy included multiparametric magnetic resonance imaging reader oversight, presence of magnetic resonance imaging invisible cancer, fusion biopsy technique error and intralesion Gleason heterogeneity.
conclusionsMagnetic resonance imaging and fusion biopsy rarely missed clinically significant prostate cancer as only 62 of 1,003 cases (6.2%) were upgraded to clinically significant disease by systematic biopsy. Imaging and biopsy techniques are continually refined. Further studies will help clarify mechanisms of fusion biopsy failure and the patient populations that benefit from systematic biopsy in addition to fusion biopsy.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.