ArticleJournal of the American College of Radiology : JACR2023
MRI-Targeted, Systematic, or Combined Biopsy for Detecting Clinically Significant Prostate Cancer.
Article in Journal of the American College of Radiology : JACR, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Diagnosis of Prostate Cancer: A Comparative Evaluation of Biological Techniques.Diseases (Basel, Switzerland) · 2026Review
- Article
- Optimizing Prostate Biopsy Pathways: Integrating MRI-Targeted, Systematic Sampling, and Clinical Judgment in the PSA-Era.Diagnostics (Basel, Switzerland) · 2026Review
- Clinical and MRI features for predicting maximum cancer involvement of >50% in a single biopsy core among patients diagnosed with prostate cancer at initial systematic biopsy: a machine learning study.American journal of cancer research · 2026Article
- Patients with multiple mpMRI region of interests: should we omit targeted biopsies of secondary lesions?Abdominal radiology (New York) · 2025Article
- Diagnostic Superiority of Transperineal Combined Fusion Biopsy Versus Transrectal Ultrasound-Guided Biopsy: Lower Upgrading Rates and Better Concordance with Post-Surgical Histopathology.Journal of clinical medicine · 2025Article
- Current practice and perceptions of multiparametric magnetic resonance imaging and multiparametric ultrasound and prostatic biopsies for prostate cancer diagnosis in China: a nationwide survey.Quantitative imaging in medicine and surgery · 2025Article
- Optimizing the strategies to perform prostate biopsy in MRI-positive patients: a systematic review and network meta-analysis.EClinicalMedicine · 2025Article
- Time-Intensity Curve parametric imaging as a novel quantitative biomarker: enhancing diagnostic accuracy and inter-rater reliability in prostate cancer ultrasound.Frontiers in oncology · 2025Article
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10 authors.
Funding
Abstract
purposeThe aim of this study was to assess MRI-targeted, systematic, or combined prostate biopsy for diagnosing prostate cancer to identify opportunities for diagnostic accuracy improvement.
methodsThis institutional review board-approved, retrospective study, performed at a large, quaternary hospital, included all men undergoing prostate multiparametric MRI (mpMRI) from January 1, 2015, to December 31, 2019, with prostate-specific antigen ≥ 4 ng/mL, biopsy target on mpMRI (Prostate Imaging Reporting and Data System [PI-RADS] 3-5 lesion), and combined targeted and systematic biopsy ≤6 months after MRI. Analysis included the highest grade lesion per patient. The primary outcome was prostate cancer diagnosis by grade group (GG; 1, 2, and ≥3). Secondary outcomes were rates of cancer upgrading by biopsy type and cancer proximity to the targeted biopsy site in patients upgraded by systematic biopsy.
resultsTwo hundred sixty-seven biopsies (267 patients) were included; 94.4% (252 of 267) were biopsy naive. The most suspicious mpMRI lesion was PI-RADS 3 in 18.7% (50 of 267), PI-RADS 4 in 52.4% (140 of 267), and PI-RADS 5 in 28.8% (77 of 267). Prostate cancer was diagnosed in 68.5% (183 of 267): 22.1% (59 of 267) GG 1, 16.1% (43 of 267) GG 2, and 30.3% (81 of 267) GG ≥ 3. Combined biopsy (124 of 267) yielded more GG ≥ 2 prostate cancer diagnoses than systematic (87 of 267) or targeted (110 of 267) biopsy alone. More GG ≥ 2 cancers were upgraded by targeted biopsy than by systematic biopsy (P = .0062). Systematic biopsy upgrades were in close proximity to the targeted biopsy site in 42.1% (24 of 57); GG ≥ 3 cancers 62.5% (15 of 24) constituted most proximal misses.
conclusionsIn men with prostate-specific antigen ≥ 4 ng/mL and PI-RADS 3, 4, or 5 lesion on mpMRI, combined biopsy led to more prostate cancer diagnoses than targeted or systematic biopsy alone. Cancers upgraded by systematic biopsy proximal and distant from the targeted biopsy site may indicate opportunities for biopsy and mpMRI improvement, respectively.
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