Objective: The implications of magnetic resonance imaging-targeted biopsy (MRI-TBx) versus transrectal ultrasound-guild biopsy (TRUS-Bx) are not well understood. To update the current evidence on the diagnostic efficacy of the MRI-TBx with TRUS-Bx for prostate cancer detection .
Methods: A comprehensive literature review was conducted in Medline, Web of Science, Embase prior to January 1, 2016. We included studies that comparing MRI-TBx and TRUS-Bx in detection of overall prostate cancer and significant cancer. The meta-analysis was conducted with RevMan 5.3, and data was presented as risk difference (RD) and 95% confidence interval (CI).
Results: Thirty-one clinical trials with a total of 11,117 participants were ultimately enrolled in this meta-analysis. Overall, MRI-TBx had a higher rate of overall prostate cancer detection and significant cancer detection compared to TRUS-Bx (RD: 0.08; 95% CI, 0.04–0.12; P<0.01 and RD: 0.16; 95% CI, 0.12–0.19; P<0.01). In subset of patients with initial biopsy, MRI-TBx showed a significant advantage in significant cancer detection over TRUS-Bx (RD: 0.16; 95% CI, 0.10–0.21; P<0.01). In addition, we also found an improvement in overall prostate cancer detection and significant cancer detection by MRI-TBx in men with previous negative biopsy (RD: 0.09; 95% CI, 0.03–0.14; P<0.01; and RD: 0.18; 95% CI, 0.11–0.25; P<0.01).
Conclusions: The existing evidence indicates that MRI-TBx is more efficient than TRUS-Bx for overall prostate cancer detection and significant cancer detection, especially for patients with prior negative biopsy. In addition, MRI-TBx had a higher rate of detection of significant prostate cancer in men with initial biopsy compared with TRUS-Bx.
