%0 Journal Article
%A Schoots, Ivo G
%A Ahmed, Hashim U
%A Albers, Peter
%A Asbach, Patrick
%A van den Bergh, Roderick C N
%A Godtman, Rebecka A
%A van Leeuwen, Pim J
%A Nordström, Tobias
%A Punwani, Shonit
%A Wallström, Jonas
%A Padhani, Anwar R
%T Magnetic Resonance Imaging-based Biopsy Strategies in Prostate Cancer Screening: A Systematic Review.
%J European urology
%V 88
%N 3
%@ 0302-2838
%C Amsterdam [u.a.]
%I Elsevier Science
%M DKFZ-2025-01228
%P 247-260
%D 2025
%Z 2025 Sep;88(3):247-260
%X Prostate cancer (PCa) screening using prostate-specific antigen (PSA) thresholding and systematic biopsies reduces advanced disease presentations and cancer-specific mortality, but also leads to overdiagnosis. Magnetic resonance imaging (MRI) integration may maintain screening benefits, while reducing overdiagnosis and unnecessary biopsies. This review analyses the benefit-harm balance when MRI is integrated as first-line and second-stage (after PSA >3 ng/ml) test in PCa screening.Following the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines, we performed a PROSPERO-registered systematic review (CRD420251006926). Literature searches identified five first-line and four second-stage MRI screening studies. We assessed MRI strategies (first-line/second-stage and risk thresholds), biopsy avoidance, and biopsy methods (targeted/systematic) for histological outcomes (grade group [GG] ≥2/GG 1 cancer detection and benign biopsies). Benefit-to-harm ratios of >1 suggest a positive net benefit.First-line MRI screening detects twice as many men with GG ≥2 cancer as second-stage MRI screening but has more MRI-negative men (range, 66-89
%K Diagnosis (Other)
%K Image-guided biopsy (Other)
%K Magnetic resonance imaging (Other)
%K Prostatic neoplasms (Other)
%K Screening (Other)
%F PUB:(DE-HGF)16
%9 Journal Article
%$ pmid:40514255
%R 10.1016/j.eururo.2025.05.038
%U https://inrepo02.dkfz.de/record/302037