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

Article Radiology, Nuclear Medicine & Medical Imaging

Risk-based MRI-directed diagnostic pathway outperforms non-risk-based pathways in suspected prostate cancer biopsy-naive men: a large cohort validation study

Leonardo Kayat Bittencourt et al.

Summary: This study aims to compare and investigate the performance of different diagnostic pathways for prostate cancer, in order to reduce biopsy avoidance, accurately diagnose clinically significant prostate cancer, and reduce overdiagnosis of clinically insignificant cancer. The results of the study showed that the risk-based MRI-directed pathway was optimal in balancing accurate diagnosis, reducing overdiagnosis, and maximizing biopsy avoidance.

EUROPEAN RADIOLOGY (2022)

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Article Urology & Nephrology

The Is mpMRI Enough or IMRIE Study: A Multicentre Evaluation of Prebiopsy Multiparametric Magnetic Resonance Imaging Compared with Biopsy

Thomas Stonier et al.

Summary: The study found that multiparametric MRI can accurately rule out csPCa in a real-world setting, potentially allowing about one-third of men to avoid immediate biopsy. However, patients should be informed about the risk of missing some significant cancers.

EUROPEAN UROLOGY FOCUS (2021)

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Letter Pathology

The 2019 International Society of Urological Pathology (ISUP) Consensus Conference on Grading of Prostatic Carcinoma

Kenneth A. Iczkowski et al.

AMERICAN JOURNAL OF SURGICAL PATHOLOGY (2021)

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Article Radiology, Nuclear Medicine & Medical Imaging

Avoiding Unnecessary Biopsy: MRI-based Risk Models versus a PI-RADS and PSA Density Strategy for Clinically Significant Prostate Cancer

Dominik Deniffel et al.

Summary: Comparing MRI-based risk models with PSAd-based strategy can effectively reduce unnecessary prostate biopsies. In a risk-averse scenario, the PSAd strategy can guide biopsy decisions better than MRI-based risk models.

RADIOLOGY (2021)

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Review Oncology

Positive Predictive Value of Prostate Imaging Reporting and Data System Version 2 for the Detection of Clinically Significant Prostate Cancer: A Systematic Review and Meta-analysis

Elio Mazzone et al.

Summary: This meta-analysis found that the PPV of mpMRI is highly dependent on disease prevalence, with main factors affecting PPV being PI-RADS version 2 scores and prior biopsy status. PPV for csPCa increased with higher PI-RADS scores and was influenced by cancer prevalence. Study design, TBx technique, and number of sampled cores did not affect PPV significantly.

EUROPEAN UROLOGY ONCOLOGY (2021)

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Article Urology & Nephrology