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MRI-targeted or sta...
MRI-targeted or standard biopsy for prostate-cancer diagnosis
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- Kasivisvanathan, Veeru (author)
- University College London
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- Rannikko, Antti S. (author)
- Helsinki University Central Hospital
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- Borghi, Marcelo (author)
- Centro de Urología, Buenos Aires
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- Panebianco, Valeria (author)
- Sapienza University of Rome
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- Mynderse, Lance A. (author)
- Mayo Clinic Minnesota
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- Vaarala, Markku H. (author)
- Oulu University Hospital
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- Briganti, Alberto (author)
- Vita-Salute San Raffaele University
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- Budäus, Lars (author)
- University Medical Center Hamburg-Eppendorf
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- Hellawell, Giles (author)
- Ealing Hospital
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- Hindley, Richard G. (author)
- Great Ormond Street Hospital
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- Roobol, Monique J. (author)
- Erasmus University Medical Center
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- Eggener, Scott (author)
- University of Chicago
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- Ghei, Maneesh (author)
- National Health Service Trust, NHS England
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- Villers, Arnauld (author)
- Lille University Hospital
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- Bladou, Franck (author)
- Jewish General Hospital
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- Villeirs, Geert M. (author)
- Ghent University Hospital
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- Virdi, Jaspal (author)
- Princess Alexandra Hospital NHS Trust
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- Boxler, Silvan (author)
- Bern University Hospital
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- Robert, Grégoire (author)
- University of Bordeaux
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- Singh, Paras B. (author)
- Great Ormond Street Hospital
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- Venderink, Wulphert (author)
- Radboud University Nijmegen
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- Hadaschik, Boris A. (author)
- University Hospital Heidelberg,University Hospital Essen
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- Ruffion, Alain (author)
- Centre Hospitalier Lyon Sud
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- Hu, Jim C. (author)
- New York Presbyterian Hospital/Columbia University Medical Center
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- Margolis, Daniel (author)
- New York Presbyterian Hospital/Columbia University Medical Center
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- Crouzet, Sébastien (author)
- Lyon Civil Hospital / Hospices Civils de Lyon
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- Klotz, Laurence (author)
- Sunnybrook Health Sciences Centre
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- Taneja, Samir S. (author)
- NYU Langone
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- Pinto, Peter (author)
- National Institutes of Health, United States
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- Gill, Inderbir (author)
- University of Southern California
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- Allen, Clare (author)
- University College London
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- Giganti, Francesco (author)
- University College London
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- Freeman, Alex (author)
- University College London
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- Morris, Stephen (author)
- University College London
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- Punwani, Shonit (author)
- University College London
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- Williams, Norman R. (author)
- University College London
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- Brew-graves, Chris (author)
- University College London
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- Deeks, Jonathan (author)
- University of Birmingham
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- Takwoingi, Yemisi (author)
- University of Birmingham
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- Emberton, Mark (author)
- University College London
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- Moore, Caroline M. (author)
- University College London
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- Kenttämies, Anu (author)
- Helsinki University Central Hospital
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- Mirtti, Tuomas (author)
- Helsinki University Central Hospital
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- Becher, Edgardo F. (author)
- University College London
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- Catalano, Carlo (author)
- Sapienza University of Rome
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- Grompone, Marcello (author)
- Sapienza University of Rome
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- Del Monte, Maurizio (author)
- Sapienza University of Rome
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- Costantino, Leonardo (author)
- Sapienza University of Rome
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- Sciarra, Alessandro (author)
- Sapienza University of Rome
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- Bjartell, Anders (creator_code:cre_t)
- Lund University,Lunds universitet,Urologisk cancerforskning, Malmö,Forskargrupper vid Lunds universitet,Urological cancer, Malmö,Lund University Research Groups
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(creator_code:org_t)
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- 2018
- 2018
- English 11 s.
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In: New England Journal of Medicine. - 0028-4793. ; 378:19, s. 1767-1777
- Related links:
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http://dx.doi.org/10...
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https://lup.lub.lu.s...
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https://doi.org/10.1...
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Abstract
Subject headings
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- BACKGROUND: Multiparametric magnetic resonance imaging (MRI), with or without targeted biopsy, is an alternative to standard transrectal ultrasonography-guided biopsy for prostate-cancer detection in men with a raised prostate-specific antigen level who have not undergone biopsy. However, comparative evidence is limited. METHODS: In a multicenter, randomized, noninferiority trial, we assigned men with a clinical suspicion of prostate cancer who had not undergone biopsy previously to undergo MRI, with or without targeted biopsy, or standard transrectal ultrasonography-guided biopsy. Men in the MRI-targeted biopsy group underwent a targeted biopsy (without standard biopsy cores) if the MRI was suggestive of prostate cancer; men whose MRI results were not suggestive of prostate cancer were not offered biopsy. Standard biopsy was a 10-to-12-core, transrectal ultrasonography-guided biopsy. The primary outcome was the proportion of men who received a diagnosis of clinically significant cancer. Secondary outcomes included the proportion of men who received a diagnosis of clinically insignificant cancer. RESULTS: A total of 500 men underwent randomization. In the MRI-targeted biopsy group, 71 of 252 men (28%) had MRI results that were not suggestive of prostate cancer, so they did not undergo biopsy. Clinically significant cancer was detected in 95 men (38%) in the MRI-targeted biopsy group, as compared with 64 of 248 (26%) in the standard-biopsy group (adjusted difference, 12 percentage points; 95% confidence interval [CI], 4 to 20; P = 0.005). MRI, with or without targeted biopsy, was noninferior to standard biopsy, and the 95% confidence interval indicated the superiority of this strategy over standard biopsy. Fewer men in the MRI-targeted biopsy group than in the standard-biopsy group received a diagnosis of clinically insignificant cancer (adjusted difference, -13 percentage points; 95% CI, -19 to -7; P<0.001). CONCLUSIONS: The use of risk assessment with MRI before biopsy and MRI-targeted biopsy was superior to standard transrectal ultrasonography-guided biopsy in men at clinical risk for prostate cancer who had not undergone biopsy previously. (Funded by the National Institute for Health Research and the European Association of Urology Research Foundation; PRECISION ClinicalTrials.gov number, NCT02380027.)
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Urologi och njurmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Urology and Nephrology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Radiologi och bildbehandling (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Radiology, Nuclear Medicine and Medical Imaging (hsv//eng)
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- art (subject category)
- ref (subject category)
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Kasivisvanathan, ...
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Rannikko, Antti ...
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Borghi, Marcelo
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Panebianco, Vale ...
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Mynderse, Lance ...
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Vaarala, Markku ...
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show more...
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Briganti, Albert ...
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Budäus, Lars
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Hellawell, Giles
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Hindley, Richard ...
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Roobol, Monique ...
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Eggener, Scott
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Ghei, Maneesh
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Villers, Arnauld
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Bladou, Franck
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Villeirs, Geert ...
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Virdi, Jaspal
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Boxler, Silvan
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Robert, Grégoire
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Singh, Paras B.
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Venderink, Wulph ...
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Hadaschik, Boris ...
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Ruffion, Alain
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Hu, Jim C.
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Margolis, Daniel
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Crouzet, Sébasti ...
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Klotz, Laurence
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Taneja, Samir S.
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Pinto, Peter
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Gill, Inderbir
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Allen, Clare
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Giganti, Frances ...
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Freeman, Alex
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Morris, Stephen
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Punwani, Shonit
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Williams, Norman ...
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Brew-graves, Chr ...
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Deeks, Jonathan
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Takwoingi, Yemis ...
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Emberton, Mark
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Moore, Caroline ...
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Kenttämies, Anu
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Mirtti, Tuomas
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Becher, Edgardo ...
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Catalano, Carlo
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Grompone, Marcel ...
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Del Monte, Mauri ...
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Costantino, Leon ...
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Sciarra, Alessan ...
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Bjartell, Anders
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cancer and Oncol ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Urology and Neph ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Radiology Nuclea ...
- Articles in the publication
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New England Jour ...
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Lund University