A comparison of magnetic resonance imaging techniques used to secure biopsies in prostate cancer patients

• Published in: Expert review of anticancer therapy Vol. 19; no. 8; pp. 705 - 716
• Main Authors: van Luijtelaar, Annemarijke, Bomers, Joyce, Fütterer, Jurgen
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis 03-08-2019
• Subjects: Biopsy; cognitive fusion; Digital Rectal Examination - methods; Humans; image fusion; Image-Guided Biopsy - methods; magnetic resonance imaging; Magnetic Resonance Imaging - methods; Male; MRI-TRUS fusion; multiparametric MRI; Neoplasm Grading; prostate cancer; Prostate-Specific Antigen - blood; Prostatic Neoplasms - diagnosis; Prostatic Neoplasms - pathology; Sensitivity and Specificity; software fusion; systematic biopsy; transrectal ultrasound; multiparametric MRI; transrectal ultrasound; magnetic resonance imaging; prostate cancer; software fusion; Biopsy; image fusion; MRI-TRUS fusion; cognitive fusion; systematic biopsy
• ISSN: 1473-7140; 1744-8328
• DOI: 10.1080/14737140.2019.1641086

Introduction: Prostate cancer (PCa) is the most common diagnosed malignancy among the male population in the United States. The incidence is increasing with an estimated amount of 175.000 cases in 2019.
Areas covered: Primarily, PCa is generally detected by an elevated or rising serum prostate-specific antigen (PSA) and digital rectal examination (DRE) followed by pathological examination. Histopathology ultimately confirms the presence of PCa and determines a Gleason score. However, PSA and DRE have low specificity and sensitivity, respectively. Subsequently, accurate assessment of the aggressiveness of PCa is essential to prevent overdiagnosis and thus overtreatment of low-risk or indolent cancers. By visualizing PCa suspicious lesions and sampling them during the targeted biopsy, it is likely that the diagnostic accuracy of significant PCa improves. This article reviews the current imaging techniques used to secure biopsies in patients with a suspicion of PCa. The advantages and limitations of each technique are described.
Expert opinion: Multiparametric magnetic resonance imaging (mpMRI) and subsequent-targeted biopsy have improved the diagnostic accuracy of PCa detection in men with an elevated or rising serum PSA. Prostate lesions visible on mpMRI are easily targeted during either in-bore MRI-guided biopsy, cognitive fusion biopsy or MRI-TRUS fusion biopsy.