MRI/TRUS fusion software-based targeted biopsy: The new standard of care? - Abstract

The advent of multiparametric MRI has made it possible to change the way in which prostate biopsy is done allowing to direct biopsies to suspicious lesions rather than randomly.

The subject of this review relates to a computer-assisted strategy, the MRI/US fusion software-based targeted biopsy, and to its performance against the other sampling methods. Different devices with different methods to register MR images to live TRUS are currently in use to allow software-based targeted biopsy. Main clinical indications of MRI/US fusion software-based targeted biopsy are re-biopsy in men with persistent suspicious of prostate cancer after first negative standard biopsy and the follow up of patients under active surveillance. Some studies have compared MRI/US fusion software-based targeted versus standard biopsy. In men at risk with MRIsuspicious lesion, targeted biopsy consistently detects more men with clinically significant disease as compared to standard biopsy; some studies have also shown decreased detection of insignificant disease. Only two studies directly compared MRI/US fusion software-based targeted biopsy with MRI/US fusion visual targeted biopsy, and the diagnostic ability seems to be in favor of the software approach. To date, no study comparing software-based targeted biopsy against in-bore MRI biopsy is available. The new software-based targeted approach seems to have the characteristics to be added in the standard pathway for achieving accurate risk stratification. Once reproducibility and cost-effectiveness will be verified, the actual issue will be to determine whether MRI/TRUS fusion software-based targeted biopsy represents anadd-on test or a replacement to standard TRUS biopsy.

Written by:
Manfredi M, Costa Moretti TB, Emberton M, Villers A, Valerio M.   Are you the author?
Department of Urology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Turin, Italy.  

Reference: Minerva Urol Nefrol. 2015 May 27. Epub ahead of print.

PubMed Abstract
PMID: 26013952 Prostate Cancer Section