4.5 Review

Review article: MRI-targeted biopsies for prostate cancer diagnosis and management

Journal

WORLD JOURNAL OF UROLOGY
Volume 39, Issue 1, Pages 57-63

Publisher

SPRINGER
DOI: 10.1007/s00345-020-03182-3

Keywords

MRI-targeted biopsy; Prostate biopsy; Prostate cancer diagnostics; MRI prostate

Funding

  1. Wellcome Trust [204998/Z/16/Z] Funding Source: Wellcome Trust
  2. Wellcome Trust [204998/Z/16/Z] Funding Source: Medline

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Traditionally, transrectal ultrasound (TRUS)-guided biopsy has been used in detecting prostate cancer, but alternative methods such as transperineal template biopsy are being explored. Current research is focused on refining biopsy techniques to maximize detection of significant cancers while minimizing risks and complications. MRI-targeted prostate biopsy has shown to be effective in detecting significant cancers and is an essential component in the diagnostic pathway of prostate cancer.
Purpose Transrectal ultrasound (TRUS)-guided biopsy has been the traditional biopsy route in the detection of prostate cancer. However, due to concern regarding overdetection of low-risk cancer and missed clinically significant cancers as well as risk of sepsis, alternative approaches have been explored. Transperineal template biopsy-sampling the gland every 5 m to 10 mm-reduces error by sampling the whole prostate but increases risk of detecting clinically insignificant cancers as well as conferring risks of side effects such as urinary retention and bleeding. Methods There are various targeted biopsy techniques, each with different cancer detection rates, costs and learning curves. Current research focuses on refining biopsy methodology to maximize detection of significant cancers, whilst minimising invasiveness and complications. In this article, the up-to-date research data about MRI-targeted prostate biopsy were reviewed to show its utilization in prostate cancer management and diagnosis. Results and conclusion Prostate multiparametric MRI has become an effective tool in the detection of significant cancers and an essential component of the prostate cancer diagnostic pathway incorporating MRI-guided biopsy decisions.

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