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Absolute added values of targeted and systematic biopsies for ISUP grade ≥ 2 and ≥ 3 Cancer Detection

Additional information
16.4.2025
EAU guideline panel
ISUP>2ISUP>3
*Intervals in parenthesis are 95% CI.
The absolute added value of a given biopsy technique is defined by the percentage of patients of the entire cohort diagnosed only by this biopsy technique.
ISUP = International Society of Urological Pathology (grade); MRI-TBx = magnetic resonance imaging-targeted biopsies; ND = not defined.
ISUP gradeCochrane meta-analysis*  «Drost FH, Osses DF, Nieboer D, ym. Prostate MRI, with or without MRI-targeted biopsy, and systematic biopsy for detecting prostate cancer. Cochrane Database Syst Rev 2019;4(4):CD012663 »1MRI-FIRST trial*  «Rouvière O, Puech P, Renard-Penna R, ym. Use of prostate systematic and targeted biopsy on the basis of multiparametric MRI in biopsy-naive patients (MRI-FIRST): a prospective, multicentre, paired dia»24M trial  «van der Leest M, Cornel E, Israël B, ym. Head-to-head Comparison of Transrectal Ultrasound-guided Prostate Biopsy Versus Multiparametric Prostate Resonance Imaging with Subsequent Magnetic Resonance-g»3Cochrane meta-analysis*  «Drost FH, Osses DF, Nieboer D, ym. Prostate MRI, with or without MRI-targeted biopsy, and systematic biopsy for detecting prostate cancer. Cochrane Database Syst Rev 2019;4(4):CD012663 »1MRI-FIRST trial*  «Rouvière O, Puech P, Renard-Penna R, ym. Use of prostate systematic and targeted biopsy on the basis of multiparametric MRI in biopsy-naive patients (MRI-FIRST): a prospective, multicentre, paired dia»24M trial «van der Leest M, Cornel E, Israël B, ym. Head-to-head Comparison of Transrectal Ultrasound-guided Prostate Biopsy Versus Multiparametric Prostate Resonance Imaging with Subsequent Magnetic Resonance-g»3 
Biopsy-naïveAdded value of MRI-TBx6.3%
(4.8–8.2)		7.6%
(4.6–11.6)		7.0% (ND)4.7%
(3.5–6.3)		6.0%
(3.4–9.7)		3.2% (ND)
Added value of systematic biopsy4.3%
(2.6–6.9)		5.2%
(2.8–8.7)		5.0% (ND)2.8%
(1.7–4.8)		1.2%
(0.2–3.5)		4.1% (ND)
Overall prevalence27.7% (23.7–32.6)37.5% (31.4–43.8)30% (ND)15.5% (12.6–19.5)21.1% (16.2–26.7)15% (ND)
Prior negative biopsyAdded value of MRI-TBx9.6%
(7.7–11.8)		--6.3%
(5.2–7.7)		--
Added value of
systematic biopsy		2.3%
(1.2–4.5)		--1.1%
(0.5–2.6)		--
Overall prevalence22.8% (20.0–26.2)--12.6% (10.5–15.6)--

References

  1. Drost FH, Osses DF, Nieboer D, ym. Prostate MRI, with or without MRI-targeted biopsy, and systematic biopsy for detecting prostate cancer. Cochrane Database Syst Rev 2019;4(4):CD012663 «PMID: 31022301»PubMed
  2. Rouvière O, Puech P, Renard-Penna R, ym. Use of prostate systematic and targeted biopsy on the basis of multiparametric MRI in biopsy-naive patients (MRI-FIRST): a prospective, multicentre, paired diagnostic study. Lancet Oncol 2019;20(1):100-109 «PMID: 30470502»PubMed
  3. van der Leest M, Cornel E, Israël B, ym. Head-to-head Comparison of Transrectal Ultrasound-guided Prostate Biopsy Versus Multiparametric Prostate Resonance Imaging with Subsequent Magnetic Resonance-guided Biopsy in Biopsy-naïve Men with Elevated Prostate-specific Antigen: A Large Prospective Multicenter Clinical Study. Eur Urol 2019;75(4):570-578 «PMID: 30477981»PubMed