TY  - JOUR
AU  - Handke, Analena Elisa
AU  - Albers, Peter
AU  - Schimmöller, Lars
AU  - Bonekamp, David
AU  - Asbach, Patrick
AU  - Schlemmer, Heinz-Peter
AU  - Hadaschik, Boris A
AU  - Radtke, Jan Philipp
TI  - Systematic or targeted fusion-guided biopsy.[Systematische oder gezielte Fusionsbiopsie der Prostata.]
JO  - Die Urologie
VL  - 62
IS  - 5
SN  - 2731-7064
CY  - New York]
PB  - Springer Medizin
M1  - DKFZ-2023-00576
SP  - 464-472
PY  - 2023
N1  - #LA:E010# / 2023 May;62(5):464-472
AB  - Early detection of prostate cancer (PCa) is associated with a high risk for detecting low-risk disease. In the primary biopsy indication, systematic biopsy leads to an increased detection of clinically insignificant PCa, and significant prostate cancers are not detected with sufficient sensitivity, especially without prior magnetic resonance imaging (MRI). Similar data have recently become available for PCa screening.In light of the current literature, this article aims to discuss the data on systematic and combined targeted and systematic multiparametric MRI (mpMRI)-guided fusion biopsy to improve PCa diagnosis in clinically suspected cancer even in screening using multivariable risk stratification.Literature review on mpMRI and MRI/TRUS fusion biopsy (TRUS: transrectal ultrasonography) for tumor detection in suspected prostate cancer and PCa screening was performed.Multiparametric MRI as a reflex test after prostate-specific antigen (PSA) determination (PSA cut-off 4 ng/ml) in combination with targeted biopsy alone reduces the detection of clinically nonsignificant tumors in early detection by half. On the other hand, in the form of a target saturation or in combination with a systematic biopsy, the sensitivity for the detection of cancers of International Society of Urogenital Pathology (ISUP) grade groups 2 or higher can be improved. Similar results are also shown in PCa screening with a PSA cut-off of 3 ng/ml.The evidence for performing a targeted fusion biopsy alone is currently insufficient. Therefore, the combination of mpMRI-guided targeted and systematic biopsy continues to be the recommended standard for prostate cancer diagnosis.
KW  - Multiparametric MRI (Other)
KW  - Overdiagnosis (Other)
KW  - Prostate cancer (Other)
KW  - Prostate-specific antigen (Other)
KW  - Risk stratification (Other)
LB  - PUB:(DE-HGF)16
C6  - pmid:36941382
DO  - DOI:10.1007/s00120-023-02062-z
UR  - https://inrepo02.dkfz.de/record/274376
ER  -