BJU international · 2026
Micro-ultrasonography- vs MRI-targeted biopsy in prostate cancer: Updated systematic review and meta-analysis.
СтатьяСистематический обзорМетаанализСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Micheleto José Pedro Cassemiro, Suzuki Tallys Ávila, Santos Lucas Amorim, Sales Luann Porpino, Lopes Roberto Iglesias, Martins Bárbara Miranda, Aguiar Melão Bárbara Vieira Lima, Cordeiro Mauricio Dener, Sharour Walid, Shabana Walid, Nahas William Carlos, Ribeiro Filho Leopoldo Alves, Suartz Caio Vinicius
Аннотация
OBJECTIVE: To refine prostate cancer (PCa) pathways by comparing micro-ultrasonography-targeted biopsy (micro-US-TBx) with magnetic resonance imaging (MRI)-TBx for detecting clinically significant PCa (csPCa) and by evaluating diagnostic accuracy (sensitivity, specificity, positive predictive value, negative predictive value).
METHODS: The Medical Literature Analysis and Retrieval System Online (MEDLINE; PubMed), Excerpta Medica dataBASE (EMBASE), and ClinicalTrials.gov were searched on 4 July 2025 and updated 5 August 2025, without language/date limits. Eligible randomised and observational studies compared micro-US-TBx vs MRI-TBx (± systematic biopsy) in men with suspected PCa or on active surveillance; csPCa was Gleason Grade Group ≥2. Two reviewers screened/extracted per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines; quality was assessed with the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Detection ratios (DRs) were pooled with random-effects models; diagnostic accuracy used a bivariate random-effects model from 2 × 2 tables. Certainty of evidence was rated with the Grading of Recommendations, Assessment, Development, and Evaluation framework.
RESULTS: A total of 22 studies (micro-US-TBx = 5581; MRI-TBx = 5937) were included. Micro-US-TBx detected 2037 csPCa cases and MRI-TBx 2043. The pooled DR (micro-US-TBx vs MRI-TBx) was 1.04 (95% confidence interval 0.95-1.15; I2 = 61.1%). Pooled sensitivity/specificity were 0.88/0.25 for micro-US-TBx and 0.81/0.17 for MRI-TBx. Summary receiver operating characteristic curves overlapped (area under the curve: micro-US, 0.658; MRI, 0.547). Meta-regression found no significant modality effect on sensitivity (P = 0.192) or specificity (P = 0.257). Egger's test indicated no meaningful publication bias (P = 0.848).
CONCLUSION: The micro-US-TBx demonstrated csPCa detection and diagnostic accuracy comparable to MRI-TBx. Given its real-time imaging capability, accessibility, and potential workflow advantages, micro-US-TBx may represent a valuable complementary tool within contemporary PCa diagnostic pathways. Further cost-effectiveness studies are warranted to better define its role in clinical practice.
METHODS: The Medical Literature Analysis and Retrieval System Online (MEDLINE; PubMed), Excerpta Medica dataBASE (EMBASE), and ClinicalTrials.gov were searched on 4 July 2025 and updated 5 August 2025, without language/date limits. Eligible randomised and observational studies compared micro-US-TBx vs MRI-TBx (± systematic biopsy) in men with suspected PCa or on active surveillance; csPCa was Gleason Grade Group ≥2. Two reviewers screened/extracted per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines; quality was assessed with the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Detection ratios (DRs) were pooled with random-effects models; diagnostic accuracy used a bivariate random-effects model from 2 × 2 tables. Certainty of evidence was rated with the Grading of Recommendations, Assessment, Development, and Evaluation framework.
RESULTS: A total of 22 studies (micro-US-TBx = 5581; MRI-TBx = 5937) were included. Micro-US-TBx detected 2037 csPCa cases and MRI-TBx 2043. The pooled DR (micro-US-TBx vs MRI-TBx) was 1.04 (95% confidence interval 0.95-1.15; I2 = 61.1%). Pooled sensitivity/specificity were 0.88/0.25 for micro-US-TBx and 0.81/0.17 for MRI-TBx. Summary receiver operating characteristic curves overlapped (area under the curve: micro-US, 0.658; MRI, 0.547). Meta-regression found no significant modality effect on sensitivity (P = 0.192) or specificity (P = 0.257). Egger's test indicated no meaningful publication bias (P = 0.848).
CONCLUSION: The micro-US-TBx demonstrated csPCa detection and diagnostic accuracy comparable to MRI-TBx. Given its real-time imaging capability, accessibility, and potential workflow advantages, micro-US-TBx may represent a valuable complementary tool within contemporary PCa diagnostic pathways. Further cost-effectiveness studies are warranted to better define its role in clinical practice.