ArticleEClinicalMedicine2025
Optimizing the strategies to perform prostate biopsy in MRI-positive patients: a systematic review and network meta-analysis.
Article in EClinicalMedicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Refining biopsy strategies stratified by PI-RADS score in men: a systematic review and network meta-analysis.Nature communications · 2026Pooled it
- Prostate MRI reporting and its impact on clinical decision-making: the urologists' perspective.Abdominal radiology (New York) · 2026Review
- Antibiotic stewardship and safety in office-based transrectal prostate biopsy: a single-center retrospective analysis of complications.Journal of medicine and life · 2026Article
- Smarter, Not More: The Rationale for Reducing Systematic Cores in the MRI-Targeted Biopsy Era.The Canadian journal of urology · 2026Article
- Overdiagnosis and Overtreatment in Prostate Cancer.Diseases (Basel, Switzerland) · 2025Review
- Assessing the diagnostic accuracy of unilateral systematic biopsy combined with targeted biopsy.Frontiers in oncology · 2025Article
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Authors and funding
11 authors.
Funding
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Abstract
Background: Early detection of prostate cancer (PCa) is crucial for better patient outcomes. However, due to overdiagnosis with the current biopsy strategy, there is a need to improve and refine the biopsy strategy. The aim of this study was to thoroughly evaluate existing biopsy schemes for patients with suspicious lesions. Methods: This study conducted a systematic review and network meta-analysis following PRISMA guidelines (from their start until 15 January 2025), evaluating 13 biopsy schemes for detecting PCa in MRI-positive (PIRADS/Likert score 2-5) patients. Data from PubMed, Embase, and Cochrane databases were examined to assess the efficacy of biopsy schemes in detecting clinically significant (csPCa) and clinically insignificant (ciPCa) prostate cancer. This study is registered with PROSPERO (CRD42024551971). Findings: The analysis included 211 studies involving 74,113 individuals. When compared with the combination of systematic biopsy (SB, defined as <20 cores) and targeted biopsy (TB, defined as <6 cores) (SB+TB), ipsilateral SB with TB (ips-SB+TB) and saturation TB did not show statistically significant inferior detection rate of csPCa (ips-SB+TB: RR 0.95, 95% CrI 0.88, 1.02; saturation TB: RR 0.96, 95% CrI 0.91, 1.01). Meanwhile, there was no significant difference in csPCa detection rates for saturation SB+TB, SB+saturation TB compared to SB+TB (saturation SB+TB: RR 1.04, 95% CrI 0.98, 1.11; SB+saturation TB: RR 1.14, 95% CrI 0.999, 1.30). TB and SB alone detected significantly less csPCa than SB+TB (TB: RR 0.86, 95% CrI 0.84, 0.88; SB: RR 0.75, 95% CrI 0.73, 0.77). Saturation SB also did not show significant superiority in detecting csPCa. Additionally, saturation TB and ips-SB+TB also decrease the detection of ciPCa. (ips-SB+TB: RR 0.87, 95% CrI 0.72, 1.04; saturation TB: RR 0.76, 95% CrI 0.65, 0.88). Interpretation: The network meta-analysis reveals that saturation SB+TB and SB+saturation TB have no significant difference in csPCa detection between them and SB+TB. Meanwhile, ips-SB+TB and saturation TB are effective biopsy strategies for MRI-positive PCa patients, offering a more targeted approach for detecting csPCa. Funding: The National Natural Science Foundation of China (Grant number: 81500522) and Science & Technology Department of Sichuan Province (Grant number: 2020YFS0090, 2020YFS0046) and Cadre Health Research Project of Sichuan Province (Grant number: ZH2023-102).
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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.