📃 Paper Title: Use of prostate systematic and targeted biopsy on the basis of multiparametric MRI in biopsy-naive patients (MRI-FIRST): a prospective, multicentre, paired diagnostic study
🧍 Author: Rouvière
🕒 Year: 2019
📚 Journal: The Lancet Oncology
🌎 Country: France
ㅤContext to the study:
Can you tell me about the MRI-FIRST trial?
ㅤ✅ Take-home message of study:
The study found that using a combination of targeted biopsies based on multiparametric MRI (mpMRI) and systematic biopsies was more effective in detecting clinically significant prostate cancer in biopsy-naive patients than systematic biopsy alone. This approach may improve the diagnostic process for patients with suspected prostate cancer.
ㅤ Prospective, multicentre, paired diagnostic study
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Study participants:
The study involved 251 biopsy-naive men with suspected prostate cancer based on abnormal digital rectal examination (DRE) results and/or elevated prostate-specific antigen (PSA) levels.
Inclusion Criteria:
Men aged 18 years or older
Biopsy-naive
Suspicion of prostate cancer based on abnormal DRE and/or elevated PSA levels
Adequate mpMRI of the prostate
Able to undergo both targeted and systematic biopsies
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Key study outcomes:
Clinically significant prostate cancer (csPCa) was detected in 94 (37%) of 251 patients. Of these 94 cases, 13 (14%) were detected by systematic biopsy only, 19 (20%) by targeted biopsy only, and 62 (66%) by both techniques.
The combined approach did not miss any csPCa cases that were detected by systematic biopsy alone.
The overall detection rate of csPCa was higher with the combined approach, without a significant increase in the detection of clinically insignificant prostate cancer.
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Study Limitations:
csPCa might have been missed by both targeted and systematic biopsy in some patients.
Performance of targeted biopsy might have been reduced by systematic biopsy-induced bleeding, artefacts and gland swelling.
Interobserver agreement in MRI reporting was not assessed.
No follow-up data for patients.
Cost-effectiveness and feasibility of pre-biopsy mpMRI in all patients referred for biopsy was not assessed.
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