4.7 Editorial Material

Balancing the benefits and harms of MRI-directed biopsy pathways COMMENT

Journal

EUROPEAN RADIOLOGY
Volume 32, Issue 4, Pages 2326-2329

Publisher

SPRINGER
DOI: 10.1007/s00330-021-08535-z

Keywords

Prostate cancer; Diagnosis; Multiparametric MRI; MRI-directed biopsy; Systematic biopsy

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Before a prostate biopsy, balancing the benefits and harms of MRI results is important, as well as considering patients' preferences and tolerance. Decision curve analysis shows that combining clinical risk factors with MRI findings optimizes biopsy outcomes across a range of clinically relevant risk thresholds.
Key Points Before a prostate biopsy, the likely benefits and the harms emanating from true and false test MRI results need to be balanced. Prioritizing patients' preferences and their tolerance to potential harms are essential to assess. The decision curve analysis method is an analytical framework where the net clinical benefit is plotted against a range of risk thresholds of having important cancers, helping patients and their physicians to decide between cancer averse (important cancers being detected) and biopsy averse (biopsies avoided) strategies. The decision curve analysis method showed that the incorporation of clinical risk factors with MRI findings optimizes biopsy outcomes over a range of clinically relevant risk thresholds, compared to other biopsy strategies.

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