What to expect from a non-suspicious prostate MRI? A review.

Biopsy Humans Male Multiparametric Magnetic Resonance Imaging Predictive Value of Tests Prostatic Neoplasms / diagnostic imaging Reproducibility of Results
Biopsie prostatique Cancer de la prostate Facteurs de risque Imagerie par résonance magnétique Magnetic resonance imaging Negative predictive value Prostate biopsy Prostate cancer Risk factors Valeur predictive negative

Journal

Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie
ISSN: 1166-7087
Titre abrégé: Prog Urol
Pays: France
ID NLM: 9307844

Informations de publication

Date de publication:
Dec 2020
Historique:
received: 03 06 2020
revised: 06 07 2020
accepted: 04 09 2020
pubmed: 4 10 2020
medline: 8 7 2021
entrez: 3 10 2020
Statut: ppublish

Résumé

Many guidelines now recommend multiparametric MRI (mpMRI) prior to an initial or repeat prostate biopsy. However, clinical decision making for men with a non-suspicious mpMRI (Likert or PIRADS score 1-2) varies. To review the most recent literature to answer three questions. (1) Should we consider systematic biopsy if mpMRI is not suspicious? (2) Are there additional predictive factors that can help decide which patient should have a biopsy? (3) Can the low visibility of some cancers be explained and what are the implications? A narrative review was performed in Medline databases using two searches with the terms "MRI" and "prostate cancer" and ("diagnosis" or "biopsy") and ("non-suspicious" or "negative" or "invisible"); "prostate cancer MRI visible". References of the selected articles were screened for additional articles. Studies published in the last 5 years in English language were assessed for eligibility and selected if data was available to answer one of the three study questions. Considering clinically significant cancer as ISUP grade≥2, the negative predictive value (NPV) of mpMRI in various settings and populations ranges from 76% to 99%, depending on cancer prevalence and the type of confirmatory reference test used. NPV is higher among patients with prior negative biopsy (88-96%), and lower for active surveillance patients (85-90%). The PSA density (PSAd) with a threshold of PSAd<0.15ng/ml/ml was the most studied and relevant predictive factor used in combination with mpMRI to rule out clinically significant cancer. Finally, mpMRI-invisible tumours appear to differ from a histopathological and genetic point of view, conferring clinical advantage to invisibility. Most published data come from expert centres and results may not be reproducible in all settings. mpMRI has high diagnostic accuracy and in cases of negative mpMRI, PSA density can be used to determine which patient should have a biopsy. Growing knowledge of the mechanisms and genetics underlying MRI visibility will help develop more accurate risk calculators and biomarkers.

Sections du résumé

BACKGROUND BACKGROUND
Many guidelines now recommend multiparametric MRI (mpMRI) prior to an initial or repeat prostate biopsy. However, clinical decision making for men with a non-suspicious mpMRI (Likert or PIRADS score 1-2) varies.
OBJECTIVES OBJECTIVE
To review the most recent literature to answer three questions. (1) Should we consider systematic biopsy if mpMRI is not suspicious? (2) Are there additional predictive factors that can help decide which patient should have a biopsy? (3) Can the low visibility of some cancers be explained and what are the implications?
SOURCES METHODS
A narrative review was performed in Medline databases using two searches with the terms "MRI" and "prostate cancer" and ("diagnosis" or "biopsy") and ("non-suspicious" or "negative" or "invisible"); "prostate cancer MRI visible". References of the selected articles were screened for additional articles.
STUDY SELECTION METHODS
Studies published in the last 5 years in English language were assessed for eligibility and selected if data was available to answer one of the three study questions.
RESULTS RESULTS
Considering clinically significant cancer as ISUP grade≥2, the negative predictive value (NPV) of mpMRI in various settings and populations ranges from 76% to 99%, depending on cancer prevalence and the type of confirmatory reference test used. NPV is higher among patients with prior negative biopsy (88-96%), and lower for active surveillance patients (85-90%). The PSA density (PSAd) with a threshold of PSAd<0.15ng/ml/ml was the most studied and relevant predictive factor used in combination with mpMRI to rule out clinically significant cancer. Finally, mpMRI-invisible tumours appear to differ from a histopathological and genetic point of view, conferring clinical advantage to invisibility.
LIMITATIONS CONCLUSIONS
Most published data come from expert centres and results may not be reproducible in all settings.
CONCLUSION CONCLUSIONS
mpMRI has high diagnostic accuracy and in cases of negative mpMRI, PSA density can be used to determine which patient should have a biopsy. Growing knowledge of the mechanisms and genetics underlying MRI visibility will help develop more accurate risk calculators and biomarkers.

Identifiants

DOI: 10.1016/j.purol.2020.09.012 PMID: 33008718
pubmed: 33008718
pii: S1166-7087(20)30588-1
doi: 10.1016/j.purol.2020.09.012
pii:
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

986-999

Subventions

Organisme : Medical Research Council
ID : MR/S005897/1
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/S00680X/1
Pays : United Kingdom

Informations de copyright

Copyright © 2020 Elsevier Masson SAS. All rights reserved.

Auteurs

G Fiard (G)

UCL Division of Surgery and Interventional Science, University College London, London, UK; Department of Urology, University College London Hospital NHS Foundation Trust, London, UK; Department of Urology, Grenoble Alpes University Hospital, Grenoble, France; Université Grenoble Alpes, CNRS, Grenoble INP, TIMC-IMAG, Grenoble, France. Electronic address: g.fiard@ucl.ac.uk.

J M Norris (JM)

UCL Division of Surgery and Interventional Science, University College London, London, UK; Department of Urology, University College London Hospital NHS Foundation Trust, London, UK.

T A Nguyen (TA)

Department of urology, université de Brest, CHRU, Brest, France.

V Stavrinides (V)

UCL Division of Surgery and Interventional Science, University College London, London, UK; Department of Urology, University College London Hospital NHS Foundation Trust, London, UK.

J Olivier (J)

UCL Division of Surgery and Interventional Science, University College London, London, UK; Department of urology, Lille university, CHU Lille, Lille, France.

M Emberton (M)

UCL Division of Surgery and Interventional Science, University College London, London, UK; Department of Urology, University College London Hospital NHS Foundation Trust, London, UK.

C M Moore (CM)

UCL Division of Surgery and Interventional Science, University College London, London, UK; Department of Urology, University College London Hospital NHS Foundation Trust, London, UK.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female

Evaluation of Low-Value Services Across Major Medicare Advantage Insurers and Traditional Medicare.

Ciara Duggan, Adam L Beckman, Ishani Ganguli et al.
1.00
Humans United States Aged Cross-Sectional Studies Medicare Part C

Effectiveness of Virtual Yoga for Chronic Low Back Pain: A Randomized Clinical Trial.

Hallie Tankha, Devyn Gaskins, Amanda Shallcross et al.
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH

questionsmedicales.fr › Techniques d'investigation › Techniques cytologiques › Cytodiagnostic › Biopsie › What to expect from a non-suspicious prostate...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › What to expect from a non-suspicious prostate...
questionsmedicales.fr › Diagnostic › Techniques et procédures diagnostiques › Imagerie diagnostique › Tomographie › Imagerie par résonance magnétique › Imagerie par résonance magnétique multiparamétrique › What to expect from a non-suspicious prostate...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Méthodologie en recherche épidémiologique › Valeur prédictive des tests › What to expect from a non-suspicious prostate...
questionsmedicales.fr › Maladies urogénitales › Tumeurs de l'appareil urogénital › Tumeurs de l'appareil génital mâle › Tumeurs de la prostate › What to expect from a non-suspicious prostate...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Méthodologie en recherche épidémiologique › Reproductibilité des résultats › What to expect from a non-suspicious prostate...