Siddiqui M.M., Rais-Bahrami S., Turkbey B., George A.K., Rothwax J., Shakir N., Okoro C., Raskolnikov D., Parnes H.L., Linehan W.M., Merino M.J., Simon R.M., Choyke P.L., Wood B.J., Pinto P.A.
JAMA – Journal of the American Medical Association 2015 313:4 (390-397)
IMPORTANCE Targeted magnetic resonance (MR)/ultrasound fusion prostate biopsy has been shown to detect prostate cancer. The implications of targeted biopsy alone vs standard extended-sextant biopsy or the 2 modalities combined are not well understood. OBJECTIVE To assess targeted vs standard biopsy and the 2 approaches combined for the diagnosis of intermediate- to high-risk prostate cancer. DESIGN, SETTING, AND PARTICIPANTS Prospective cohort study of 1003 men undergoing both targeted and standard biopsy concurrently from 2007 through 2014 at the National Cancer Institute in the United States. Patients were referred for elevated level of prostate-specific antigen (PSA) or abnormal digital rectal examination results, often with prior negative biopsy results. Risk categorization was compared among targeted and standard biopsy and, when available, whole-gland pathology after prostatectomy as the “gold standard.” INTERVENTIONS Patients underwent multiparametric prostate magnetic resonance imaging to identify regions of prostate cancer suspicion followed by targeted MR/ultrasound fusion biopsy and concurrent standard biopsy. MAIN OUTCOMES AND MEASURES The primary objectivewas to compare targeted and standard biopsy approaches for detection of high-risk prostate cancer (Gleason score ?4 + 3)…(vermás)