MRI to guide biopsies or avoid biopsies?

Document Type

Journal Article

Publication Date

11-1-2018

Journal

Current Opinion in Urology

Volume

28

Issue

6

DOI

10.1097/MOU.0000000000000555

Keywords

active surveillance; multiparametric MRI; prostate biopsy; prostate cancer; prostate cancer screening

Abstract

© 2018 Wolters Kluwer Health, Inc. All rights reserved. Purpose of reviewTo discuss contemporary data on the value of multiparametric MRI (mpMRI) for guiding the decision to biopsy men at risk for prostate cancer, as well as its utility in active surveillance programs.Recent findingsAlthough a systematic 12-core biopsy is the current standard of care for men with increased suspicion for prostate cancer, MRI with or without targeted biopsy has been shown to reliably improve the detection of clinically significant disease following a prior negative biopsy. At the same time, there is a growing body of evidence to support the use of MRI for diagnostic purposes in biopsy-naive patients, as well for enrolling and monitoring men on active surveillance programs.SummarympMRI is an evolving technology with great promise for altering our approach to prostate cancer diagnosis and surveillance. In conjunction with targeted biopsies, MRI offers greater specificity for the detection of clinically significant cancer and therefore may help to reduce overdetection of indolent disease while minimizing the risks and limitations of systematic biopsies.

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