MRI-Targeted or Standard Biopsy for Prostate Cancer Diagnosis

Research output: Contribution to journalArticle

Standard

MRI-Targeted or Standard Biopsy for Prostate Cancer Diagnosis. / Kasivisvanathan, Veeru ; Rannikko, Antti S. ; Borghi, Marcelo ; Panebianco, Valeria ; Mynderse, Lance A. ; Vaarala, Markku H. ; Briganti, Alberto ; Budäus, Lars ; Hellawell, Giles ; Hindley, Richard G. ; Roobol, Monique J. ; Eggener, Scott ; Ghei, Maneesh ; Villers, Arnauld ; Bladou, Franck ; Villeirs, Geert M. ; Virdi, Jaspal ; Boxler, Silvan ; Robert, Grégoire ; Singh, Paras B. ; Venderink, Wulphert ; Hadaschik, Boris A ; Ruffion, Alain ; Hu, Jim C. ; Margolis, Daniel ; Crouzet, Sébastien ; Klotz, Laurence ; Taneja, Samir S. ; Pinto, Peter ; Gill, Inderbir ; Allen, Clare ; Giganti, Francesco ; Freeman, Alex ; Morris, Stephen ; Punwani, Shonit ; Williams, Norman R. ; Brew-Graves, Chris ; Deeks, Jonathan; Takwoingi, Yemisi; Emberton, Mark ; Moore, Caroline M. .

In: The New England Journal of Medicine, 19.03.2018.

Research output: Contribution to journalArticle

Harvard

Kasivisvanathan, V, Rannikko, AS, Borghi, M, Panebianco, V, Mynderse, LA, Vaarala, MH, Briganti, A, Budäus, L, Hellawell, G, Hindley, RG, Roobol, MJ, Eggener, S, Ghei, M, Villers, A, Bladou, F, Villeirs, GM, Virdi, J, Boxler, S, Robert, G, Singh, PB, Venderink, W, Hadaschik, BA, Ruffion, A, Hu, JC, Margolis, D, Crouzet, S, Klotz, L, Taneja, SS, Pinto, P, Gill, I, Allen, C, Giganti, F, Freeman, A, Morris, S, Punwani, S, Williams, NR, Brew-Graves, C, Deeks, J, Takwoingi, Y, Emberton, M & Moore, CM 2018, 'MRI-Targeted or Standard Biopsy for Prostate Cancer Diagnosis', The New England Journal of Medicine. https://doi.org/10.1056/NEJMoa1801993

APA

Kasivisvanathan, V., Rannikko, A. S., Borghi, M., Panebianco, V., Mynderse, L. A., Vaarala, M. H., ... Moore, C. M. (2018). MRI-Targeted or Standard Biopsy for Prostate Cancer Diagnosis. The New England Journal of Medicine. https://doi.org/10.1056/NEJMoa1801993

Vancouver

Kasivisvanathan V, Rannikko AS, Borghi M, Panebianco V, Mynderse LA, Vaarala MH et al. MRI-Targeted or Standard Biopsy for Prostate Cancer Diagnosis. The New England Journal of Medicine. 2018 Mar 19. https://doi.org/10.1056/NEJMoa1801993

Author

Kasivisvanathan, Veeru ; Rannikko, Antti S. ; Borghi, Marcelo ; Panebianco, Valeria ; Mynderse, Lance A. ; Vaarala, Markku H. ; Briganti, Alberto ; Budäus, Lars ; Hellawell, Giles ; Hindley, Richard G. ; Roobol, Monique J. ; Eggener, Scott ; Ghei, Maneesh ; Villers, Arnauld ; Bladou, Franck ; Villeirs, Geert M. ; Virdi, Jaspal ; Boxler, Silvan ; Robert, Grégoire ; Singh, Paras B. ; Venderink, Wulphert ; Hadaschik, Boris A ; Ruffion, Alain ; Hu, Jim C. ; Margolis, Daniel ; Crouzet, Sébastien ; Klotz, Laurence ; Taneja, Samir S. ; Pinto, Peter ; Gill, Inderbir ; Allen, Clare ; Giganti, Francesco ; Freeman, Alex ; Morris, Stephen ; Punwani, Shonit ; Williams, Norman R. ; Brew-Graves, Chris ; Deeks, Jonathan ; Takwoingi, Yemisi ; Emberton, Mark ; Moore, Caroline M. . / MRI-Targeted or Standard Biopsy for Prostate Cancer Diagnosis. In: The New England Journal of Medicine. 2018.

Bibtex

@article{51e311e6b3c9410a9f31701081e03040,
title = "MRI-Targeted or Standard Biopsy for Prostate Cancer Diagnosis",
abstract = "BackgroundThe use of multiparametric MRI ± targeted biopsy (MRI±TB) is an alternative to standard transrectal ultrasound guided (TRUS) biopsy for prostate cancer detection in biopsy-na{\"i}ve men with raised prostate specific antigen (PSA). However, comparative evidence is lacking.MethodsPRECISION was a randomized, multicenter, non-inferiority trial, allocating 500 biopsy-na{\"i}ve men with clinical suspicion of prostate cancer to MRI±TB or standard TRUS biopsy. Men randomized to MRI±TB had targeted biopsy (without standard biopsy cores) if the MRI was suspicious (PIRADSv2 score ≥3). Men with a non-suspicious MRI were not offered biopsy. Standard biopsy was a 10-12 core TRUS biopsy. The primary outcome was the proportion of men diagnosed with clinically significant cancer (Gleason grade ≥3+4). Planned secondary outcomes included the proportion of men diagnosed with clinically insignificant cancer (Gleason grade 3+3).ResultsOf the 252 men allocated to MRI±TB, 71 (28{\%}) had a non-suspicious MRI and did not undergo biopsy. Clinically significant cancer was detected in 95 (38{\%}) of 252 men in the MRI±TB arm compared to 64 (26{\%}) of 248 men randomized to TRUS biopsy (adjusted difference, 11.7{\%} [95{\%} CI 3.6 to 19.8], P=0.005). MRI±TB was non-inferior to TRUS biopsy and the 95{\%} CI indicated superiority of MRI±TB over TRUS biopsy. MRI±TB also diagnosed fewer men with insignificant cancer than TRUS biopsy (adjusted difference, -13.1{\%} [95{\%} CI -19.3 to -6.8, P<0.001]).ConclusionsPre-biopsy MRI risk assessment and MRI-targeted biopsy is superior to TRUS biopsy in biopsy-na{\"i}ve men at clinical risk of prostate cancer.(Funded by the National Institute for Health Research (NIHR) and the European Association of Urology Research Foundation; Trial registration number: NCT02380027)",
author = "Veeru Kasivisvanathan and Rannikko, {Antti S.} and Marcelo Borghi and Valeria Panebianco and Mynderse, {Lance A.} and Vaarala, {Markku H.} and Alberto Briganti and Lars Bud{\"a}us and Giles Hellawell and Hindley, {Richard G.} and Roobol, {Monique J.} and Scott Eggener and Maneesh Ghei and Arnauld Villers and Franck Bladou and Villeirs, {Geert M.} and Jaspal Virdi and Silvan Boxler and Gr{\'e}goire Robert and Singh, {Paras B.} and Wulphert Venderink and Hadaschik, {Boris A} and Alain Ruffion and Hu, {Jim C.} and Daniel Margolis and S{\'e}bastien Crouzet and Laurence Klotz and Taneja, {Samir S.} and Peter Pinto and Inderbir Gill and Clare Allen and Francesco Giganti and Alex Freeman and Stephen Morris and Shonit Punwani and Williams, {Norman R.} and Chris Brew-Graves and Jonathan Deeks and Yemisi Takwoingi and Mark Emberton and Moore, {Caroline M.}",
year = "2018",
month = "3",
day = "19",
doi = "10.1056/NEJMoa1801993",
language = "English",
journal = "The New England Journal of Medicine",
issn = "0028-4793",
publisher = "Massachusetts Medical Society",

}

RIS

TY - JOUR

T1 - MRI-Targeted or Standard Biopsy for Prostate Cancer Diagnosis

AU - Kasivisvanathan, Veeru

AU - Rannikko, Antti S.

AU - Borghi, Marcelo

AU - Panebianco, Valeria

AU - Mynderse, Lance A.

AU - Vaarala, Markku H.

AU - Briganti, Alberto

AU - Budäus, Lars

AU - Hellawell, Giles

AU - Hindley, Richard G.

AU - Roobol, Monique J.

AU - Eggener, Scott

AU - Ghei, Maneesh

AU - Villers, Arnauld

AU - Bladou, Franck

AU - Villeirs, Geert M.

AU - Virdi, Jaspal

AU - Boxler, Silvan

AU - Robert, Grégoire

AU - Singh, Paras B.

AU - Venderink, Wulphert

AU - Hadaschik, Boris A

AU - Ruffion, Alain

AU - Hu, Jim C.

AU - Margolis, Daniel

AU - Crouzet, Sébastien

AU - Klotz, Laurence

AU - Taneja, Samir S.

AU - Pinto, Peter

AU - Gill, Inderbir

AU - Allen, Clare

AU - Giganti, Francesco

AU - Freeman, Alex

AU - Morris, Stephen

AU - Punwani, Shonit

AU - Williams, Norman R.

AU - Brew-Graves, Chris

AU - Deeks, Jonathan

AU - Takwoingi, Yemisi

AU - Emberton, Mark

AU - Moore, Caroline M.

PY - 2018/3/19

Y1 - 2018/3/19

N2 - BackgroundThe use of multiparametric MRI ± targeted biopsy (MRI±TB) is an alternative to standard transrectal ultrasound guided (TRUS) biopsy for prostate cancer detection in biopsy-naïve men with raised prostate specific antigen (PSA). However, comparative evidence is lacking.MethodsPRECISION was a randomized, multicenter, non-inferiority trial, allocating 500 biopsy-naïve men with clinical suspicion of prostate cancer to MRI±TB or standard TRUS biopsy. Men randomized to MRI±TB had targeted biopsy (without standard biopsy cores) if the MRI was suspicious (PIRADSv2 score ≥3). Men with a non-suspicious MRI were not offered biopsy. Standard biopsy was a 10-12 core TRUS biopsy. The primary outcome was the proportion of men diagnosed with clinically significant cancer (Gleason grade ≥3+4). Planned secondary outcomes included the proportion of men diagnosed with clinically insignificant cancer (Gleason grade 3+3).ResultsOf the 252 men allocated to MRI±TB, 71 (28%) had a non-suspicious MRI and did not undergo biopsy. Clinically significant cancer was detected in 95 (38%) of 252 men in the MRI±TB arm compared to 64 (26%) of 248 men randomized to TRUS biopsy (adjusted difference, 11.7% [95% CI 3.6 to 19.8], P=0.005). MRI±TB was non-inferior to TRUS biopsy and the 95% CI indicated superiority of MRI±TB over TRUS biopsy. MRI±TB also diagnosed fewer men with insignificant cancer than TRUS biopsy (adjusted difference, -13.1% [95% CI -19.3 to -6.8, P<0.001]).ConclusionsPre-biopsy MRI risk assessment and MRI-targeted biopsy is superior to TRUS biopsy in biopsy-naïve men at clinical risk of prostate cancer.(Funded by the National Institute for Health Research (NIHR) and the European Association of Urology Research Foundation; Trial registration number: NCT02380027)

AB - BackgroundThe use of multiparametric MRI ± targeted biopsy (MRI±TB) is an alternative to standard transrectal ultrasound guided (TRUS) biopsy for prostate cancer detection in biopsy-naïve men with raised prostate specific antigen (PSA). However, comparative evidence is lacking.MethodsPRECISION was a randomized, multicenter, non-inferiority trial, allocating 500 biopsy-naïve men with clinical suspicion of prostate cancer to MRI±TB or standard TRUS biopsy. Men randomized to MRI±TB had targeted biopsy (without standard biopsy cores) if the MRI was suspicious (PIRADSv2 score ≥3). Men with a non-suspicious MRI were not offered biopsy. Standard biopsy was a 10-12 core TRUS biopsy. The primary outcome was the proportion of men diagnosed with clinically significant cancer (Gleason grade ≥3+4). Planned secondary outcomes included the proportion of men diagnosed with clinically insignificant cancer (Gleason grade 3+3).ResultsOf the 252 men allocated to MRI±TB, 71 (28%) had a non-suspicious MRI and did not undergo biopsy. Clinically significant cancer was detected in 95 (38%) of 252 men in the MRI±TB arm compared to 64 (26%) of 248 men randomized to TRUS biopsy (adjusted difference, 11.7% [95% CI 3.6 to 19.8], P=0.005). MRI±TB was non-inferior to TRUS biopsy and the 95% CI indicated superiority of MRI±TB over TRUS biopsy. MRI±TB also diagnosed fewer men with insignificant cancer than TRUS biopsy (adjusted difference, -13.1% [95% CI -19.3 to -6.8, P<0.001]).ConclusionsPre-biopsy MRI risk assessment and MRI-targeted biopsy is superior to TRUS biopsy in biopsy-naïve men at clinical risk of prostate cancer.(Funded by the National Institute for Health Research (NIHR) and the European Association of Urology Research Foundation; Trial registration number: NCT02380027)

U2 - 10.1056/NEJMoa1801993

DO - 10.1056/NEJMoa1801993

M3 - Article

JO - The New England Journal of Medicine

JF - The New England Journal of Medicine

SN - 0028-4793

ER -