TY  - JOUR
AU  - Schoots, Ivo G
AU  - Ahmed, Hashim U
AU  - Albers, Peter
AU  - Asbach, Patrick
AU  - van den Bergh, Roderick C N
AU  - Godtman, Rebecka A
AU  - van Leeuwen, Pim J
AU  - Nordström, Tobias
AU  - Punwani, Shonit
AU  - Wallström, Jonas
AU  - Padhani, Anwar R
TI  - Magnetic Resonance Imaging-based Biopsy Strategies in Prostate Cancer Screening: A Systematic Review.
JO  - European urology
VL  - 88
IS  - 3
SN  - 0302-2838
CY  - Amsterdam [u.a.]
PB  - Elsevier Science
M1  - DKFZ-2025-01228
SP  - 247-260
PY  - 2025
N1  - 2025 Sep;88(3):247-260
AB  - 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
KW  - Diagnosis (Other)
KW  - Image-guided biopsy (Other)
KW  - Magnetic resonance imaging (Other)
KW  - Prostatic neoplasms (Other)
KW  - Screening (Other)
LB  - PUB:(DE-HGF)16
C6  - pmid:40514255
DO  - DOI:10.1016/j.eururo.2025.05.038
UR  - https://inrepo02.dkfz.de/record/302037
ER  -