Evidence map›Paper›PMID 33033806›Full record

ArticleRadiology. Imaging cancer2020

In-Bore MRI-guided Prostate Biopsies in Patients with Prior Positive Transrectal US-guided Biopsy Results: Pathologic Outcomes and Predictors of Missed Cancers.

Kareem K Elfatairy, Christopher P Filson, Martin G Sanda, Adeboye O Osunkoya, Sherif G Nour

Open access · diamondAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Radiology. Imaging cancer, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
0.8field-weighted citation impact, top 24% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 9 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 3 countries.

Kareem K ElfatairyDepartment of Radiology and Imaging Sciences (K.K.E., S.G.N.), Interventional MRI Program (K.K.E., S.G.N.), Department of Urology (C.P.F., M.G.S., A.O.O.), and Department of Pathology (A.O.O.), School of Medicine, and Winship Cancer Institute (C.P.F., M.G.S., A.O.O., S.G.N.), Emory University, 1364 Clifton Rd NE, Room BG-42, Atlanta, GA 30322; Atlanta Veterans Affairs Medical Center, Decatur, Ga (C.P.F., M.G.S.); Department of Pathology, Veterans Affairs Medical Center, Atlanta, Ga (A.O.O.); and Department of Radiology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt (K.K.E.).ORCID 0000-0002-3254-9271
Christopher P FilsonDepartment of Radiology and Imaging Sciences (K.K.E., S.G.N.), Interventional MRI Program (K.K.E., S.G.N.), Department of Urology (C.P.F., M.G.S., A.O.O.), and Department of Pathology (A.O.O.), School of Medicine, and Winship Cancer Institute (C.P.F., M.G.S., A.O.O., S.G.N.), Emory University, 1364 Clifton Rd NE, Room BG-42, Atlanta, GA 30322; Atlanta Veterans Affairs Medical Center, Decatur, Ga (C.P.F., M.G.S.); Department of Pathology, Veterans Affairs Medical Center, Atlanta, Ga (A.O.O.); and Department of Radiology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt (K.K.E.).
Martin G SandaDepartment of Radiology and Imaging Sciences (K.K.E., S.G.N.), Interventional MRI Program (K.K.E., S.G.N.), Department of Urology (C.P.F., M.G.S., A.O.O.), and Department of Pathology (A.O.O.), School of Medicine, and Winship Cancer Institute (C.P.F., M.G.S., A.O.O., S.G.N.), Emory University, 1364 Clifton Rd NE, Room BG-42, Atlanta, GA 30322; Atlanta Veterans Affairs Medical Center, Decatur, Ga (C.P.F., M.G.S.); Department of Pathology, Veterans Affairs Medical Center, Atlanta, Ga (A.O.O.); and Department of Radiology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt (K.K.E.).
Adeboye O OsunkoyaDepartment of Radiology and Imaging Sciences (K.K.E., S.G.N.), Interventional MRI Program (K.K.E., S.G.N.), Department of Urology (C.P.F., M.G.S., A.O.O.), and Department of Pathology (A.O.O.), School of Medicine, and Winship Cancer Institute (C.P.F., M.G.S., A.O.O., S.G.N.), Emory University, 1364 Clifton Rd NE, Room BG-42, Atlanta, GA 30322; Atlanta Veterans Affairs Medical Center, Decatur, Ga (C.P.F., M.G.S.); Department of Pathology, Veterans Affairs Medical Center, Atlanta, Ga (A.O.O.); and Department of Radiology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt (K.K.E.).
Sherif G NourDepartment of Radiology and Imaging Sciences (K.K.E., S.G.N.), Interventional MRI Program (K.K.E., S.G.N.), Department of Urology (C.P.F., M.G.S., A.O.O.), and Department of Pathology (A.O.O.), School of Medicine, and Winship Cancer Institute (C.P.F., M.G.S., A.O.O., S.G.N.), Emory University, 1364 Clifton Rd NE, Room BG-42, Atlanta, GA 30322; Atlanta Veterans Affairs Medical Center, Decatur, Ga (C.P.F., M.G.S.); Department of Pathology, Veterans Affairs Medical Center, Atlanta, Ga (A.O.O.); and Department of Radiology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt (K.K.E.).
Emory University · USSuez Canal University · EG

Funding

Prostate Cancer Biomarker and Imaging Validation Alliance: Emory University, University of Alabama Birmingham, and University of Texas SouthwesternU01CA113913 · NCI · EMORY UNIVERSITY · PI Martin G. Sanda · 2005 to 2026
$16.4M
NCI NIH HHS U01 CA113913
6 · The paper itself

Abstract

Purpose: To evaluate the role of confirmatory in-bore MRI-guided biopsy in patients with low- or intermediate-risk disease diagnosed at prior transrectal US-guided biopsy and to evaluate the rate and predictors for missed cancers. Materials and Methods: A retrospective evaluation of 50 consecutive men who had previously undergone transrectal US-guided biopsy with positive results and who underwent subsequent in-bore MRI-guided biopsy at our university hospital (average time interval, 11 months) between 2012 and 2016 was performed. Ten men were excluded because of a history of treatment after transrectal US-guided biopsy. A total of 40 men (mean age, 63 years; range, 47-84 years) were included in this study. Multiparametric 3-T MRI (T2-weighted, diffusion-weighted, and dynamic contrast material-enhanced) and transrectal in-bore MRI-guided biopsy were performed. Cancer detection, disease-grade changes, and cancers missed at in-bore MRI-guided biopsy were evaluated. Descriptive statistics were used to report different rates. The Fisher exact test was used for categoric variables. The Mann-Whitney Results: The overall cancer detection rate when using in-bore MRI-guided biopsy was 65% (26 of 40). In-bore MRI-guided biopsy detected 14 previously undiscovered cancerous lesions (clinically significant cancers [CSCs], 57.1% [eight of 14]). An overall disease upgrade by in-bore MRI-guided biopsy occurred in 40% (16 of 40) of cases (61.5% [16 of 26] of cases with positive results from in-bore MRI-guided biopsy). One case was downgraded from a Gleason score (GS) of 3 + 4 = 7 to a GS of 3 + 3 = 6. Out of 71 sextant biopsies with positive results detected by transrectal US-guided biopsy (from all 40 patients), 80% (57 of 71) were visible on MR images (in-bore MRI-guided biopsy results were positive in 52.6% [30 of 57]), and 20% (14 of 71) had no image correlates on MR images. In-bore MRI-guided biopsy upgraded 60% (18 of 30) and downgraded 3.3% (one of 30) of detected lesions. The false-negative rate was 35% (14.2% [two of 14] of patients had CSCs; GS ≥ 7), was higher in prostate volumes of greater than 40 mL, and was lower in the anterior gland location ( Conclusion: Performing confirmatory in-bore MRI-guided biopsy following positive transrectal US-guided biopsy resulted in a high disease-upgrade incidence with subsequently improved disease-risk stratification, particularly when considering patients for active surveillance or focal therapy.

Indexed as

Image-Guided BiopsyProstatic NeoplasmsAgedAged, 80 and overHumansMagnetic Resonance ImagingMaleMiddle AgedRetrospective Studies

Identifiers

PMID33033806
PMCPMC7523503
OpenAlexW3088289791

What OpenQuestion holds

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Registered trials

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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.