Is magnetic resonance/ultrasound fusion prostate biopsy better than systematic prostate biopsy? an updated meta- and trial sequential analysis
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Jian Wu1,*, Alin Ji1,*, Bo Xie2, Xiao Wang1, Yi Zhu1, Junyuan Wang1, Yasai Yu1, Xiangyi Zheng1, Ben Liu1 and Liping Xie1
1 Department of Urology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People’s Republic of China
2 Department of Urology, Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang Province, People’s Republic of China
* These authors have contributed equally to this work
Ben liu, email:
Keywords: prostate cancer, magnetic resonance imaging, prostate biopsy, target biopsy, meta-analysis
Received: August 01, 2015 Accepted: October 11, 2015 Published: October 20, 2015
We systematically reviewed the literature to determine whether Magnetic Resonance/Ultrasound (MR/US) fusion prostate biopsy is better than systematic biopsy for making a definitive diagnosis of prostate cancer. The two strategies were also compared for their ability to detect lesions with different degrees of suspicion on MRI and clinically significant prostate cancer, and the number of cores needed for diagnosis. The Cochrane Library, Embase, Web of Knowledge, and Medline were searched from inception until May 1, 2015. Meta-analysis was conducted via RevMan 5.2 software. Data was expressed as risk ratio (RR) and 95% confidence interval. Trial sequential analysis was used to assess risk of random errors. Fourteen trials were included, encompassing a total of 3105 participants. We found that MR/US fusion biopsy detected more prostate cancers than systematic biopsy (46.9% vs. 44.2%, p=0.03). In men with moderate/high MRI suspicion, MR/US fusion biopsy did better than systematic biopsy (RR = 1.46; p < 0.05) for making a diagnosis. Moreover, MR/US fusion biopsy detected more clinically significant cancers than systematic biopsy (RR = 1.19; p < 0.05). We recommend that MR/US fusion prostate biopsy be used to better detect prostate cancer, particularly in patients with moderate/high suspicion lesions on MRI.
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