Abstract:
BACKGROUND:The role of real-time elastography (RTE)-targeted biopsy in the detection and diagnosis of prostate cancer (PCa) remains controversial. METHODS:We searched Medline, Embase, and Cochrane Library from inception to July 31, 2017 and used the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool to assess the quality of the identified studies. We applied the relative sensitivity value to assess the diagnostic accuracy of RTE-targeted biopsy using the 10-core systematic biopsy as the reference standard. RESULTS:Seven studies comprising 5 cohorts and 2 randomized controlled trials (RCTs) were included. Of the 5 cohorts that encompassed 698 participants, we found that RTE-targeted biopsy did not outperform systematic biopsy in either overall PCa detection (69.5% vs 80.5%, relative sensitivity 0.92, 95% CI 0.80-1.06) or for the initial biopsy (56.8% vs 64.0%, relative sensitivity 0.93, 95% CI 0.79-1.11). For the core-by-core analysis, more positive cores were detected by RTE-targeted biopsy than systematic biopsy (21% vs 11%, relative sensitivity 2.17, 95% CI 1.61-2.95). The 2 RCTs showed a favorable trend toward greater PCa detection when a combination of systematic biopsies and RTE-targeted biopsies was used than when systematic biopsy alone was used (45.5% vs 39.5%, risk ratio (RR) 1.18, 95% CI 0.98-1.43). CONCLUSION:Currently, there is not enough evidence to demonstrate that RTE-targeted biopsy can outperform systematic biopsy, but the combination of systematic and RTE-targeted biopsy may be a promising approach for improving PCa detection.
journal_name
Medicine (Baltimore)journal_title
Medicineauthors
Tu X,Qiu S,Chang T,Jin K,Bao Y,Yang L,Wei Qdoi
10.1097/MD.0000000000010220subject
Has Abstractpub_date
2018-03-01 00:00:00pages
e0220issue
12eissn
0025-7974issn
1536-5964pii
00005792-201803230-00045journal_volume
97pub_type
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