Cochrane · systematic review · CD012663
Prostate MRI, with or without MRI‐targeted biopsy, and systematic biopsy for detecting prostate cancer
Drost, FJH, Osses, DF, Nieboer, D, et al. · Cochrane Database of Systematic Reviews · 2019 · Cochrane Library
UrologyAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
26
current version
GRADE rated
17
No studies
4
Included studies
NR
No studies 4 · 15.4%Ungraded 5 · 19.2%Very low 0 · 0%Low 14 · 53.8%Moderate 2 · 7.7%High 1 · 3.8%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Detecting ISUP grade 2 or higher prostate cancer by MRI, MRI‐targeted biopsy, MRI‐pathway and systematic biopsy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Tests | no estimate extracted | NR | High |
MRI | no estimate extracted | 12 studies · 3091 participants | Ungraded |
MRI‐TBx | no estimate extracted | 8 studies · 1553 participants | Ungraded |
MRI pathway | no estimate extracted | 8 studies · 2257 participants | Ungraded |
SBx | no estimate extracted | 4 studies · 3421 participants | Ungraded |
MRI pathwayvs SBx | no estimate extracted | 25 studies · 6944 participants | Ungraded |
Should MRI be used to diagnose ISUP grade ≥ 2 prostate cancer in men suspected of having clinically significant prostate cancer?
Population: men suspected of having clinically significant prostate cancer undergoing their first biopsy (biopsy‐naïve men) or a repeat biopsy (prior‐negative biopsy men)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Test result | no estimate extracted | NR | No studies |
True positives | no estimate extracted | 12 studies · 3091 participants | Low |
False negatives | no estimate extracted | 12 studies · 3091 participants | Low |
True negatives | no estimate extracted | 12 studies · 3091 participants | Low |
False positives | no estimate extracted | 12 studies · 3091 participants | Low |
Should MRI‐targeted biopsy be used to diagnose ISUP grade ≥ 2 prostate cancer in men suspected of having clinically significant prostate cancer?
Population: men with a positive MRI suspected of having clinically significant prostate cancer undergoing their first biopsy (biopsy‐naïve men) or a repeat biopsy (prior‐negative biopsy men)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Test result | no estimate extracted | NR | No studies |
True positives | no estimate extracted | 8 studies · 1553 participants | Low |
False negatives | no estimate extracted | 8 studies · 1553 participants | Low |
True negatives | no estimate extracted | 8 studies · 1553 participants | Low |
False positives | no estimate extracted | 8 studies · 1553 participants | Low |
Should an MRI‐pathway be used to diagnose ISUP grade ≥ 2 prostate cancer in men suspected of having clinically significant prostate cancer?
Population: men suspected of having clinically significant prostate cancer undergoing their first biopsy (biopsy‐naïve men) or a repeat biopsy (prior‐negative biopsy men)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Test result | no estimate extracted | NR | No studies |
True positives | no estimate extracted | 8 studies · 2257 participants | Low |
False negatives | no estimate extracted | 8 studies · 2257 participants | Low |
True negatives | no estimate extracted | 8 studies · 2257 participants | Low |
False positives | no estimate extracted | 8 studies · 2257 participants | Low |
Should systematic biopsy be used to diagnose ISUP grade ≥ 2 prostate cancer in men suspected of having clinically significant prostate cancer?
Population: men suspected of having clinically significant prostate cancer undergoing their first biopsy (biopsy‐naïve men) or a repeat biopsy (prior‐negative biopsy men)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Test result | no estimate extracted | NR | No studies |
True positives | no estimate extracted | 4 studies · 3421 participants | Moderate |
False negatives | no estimate extracted | 4 studies · 3421 participants | Moderate |
True negatives | no estimate extracted | 4 studies · 3421 participants | Low |
False positives | no estimate extracted | 4 studies · 3421 participants | Low |