Targeted biopsy: Benefits and limitations

Document Type

Journal Article

Publication Date

3-1-2018

Journal

Current Opinion in Urology

Volume

28

Issue

2

DOI

10.1097/MOU.0000000000000481

Keywords

active surveillance; fusion biopsy; multiparametric MRI

Abstract

Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved. Purpose of review To review the current literature regarding the role of multiparametric MRI and fusion-guided biopsies in urologic practice. Recent findings Fusion biopsies consistently show an increase in the detection of clinically significant cancers and decrease in low-risk disease that may be more suitable for active surveillance. Although, when to incorporate multiparametric MRI into workup is not clearly agreed upon, studies have shown a clear benefit in both biopsy naïve and those with prior negative biopsies in determining the appropriate treatment strategy. More recently, cost-analysis models have been published that show that upfront MRIs are more cost-effective when considering missed cancers and treatment courses. Summary With improved accuracy over systematic biopsies, fusion biopsies are a superior method for detection of the true grade of cancer for both biopsy naïve and patients with prior negative biopsies, choosing appropriate candidates for active surveillance, and monitoring progression on active surveillance.

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