Multiparametric MRI and MRI Fusion-Guided Biopsy for the Diagnosis of Prostate Cancer: current status

Abstract

Purpose of the Review: This review article aims to explain the role of Multiparametric MRI, in particular in prostate biopsy, to detect prostate cancer. Recent Findings: The use of multiparametric MRI in the diagnosis of prostate cancer has also allowed its use in MR guided biopsies, which according to many studies present high sensitivity and specificity in early diagnosis, staging, in patients with persistently elevated PSA despite previous negative prostate biopsies , and in the follow-up of patients under active surveillance. To perform a targeted prostate biopsy, three types of MRI guidance are available: -cognitive fusion, - direct MRI-guided biopsy, performed within an MRI tube (in-bore biopsies) - software coregistration of stored MRI with real-time ultrasound, using a fusion device. with mpMRI findings digitally overlaid on real-time TRUS images for targeted biopsy Each method has its advantages and disadvantages. Summary: MRI-targeted biopsy improves the quality of histological results compared to other approaches, with approximately 90% correct detection of significant index lesions Correct staging allows you to choose the best therapeutic options, adequately evaluate the prognosis, reducing the incidence of new biopsies and complications. The current objective is to make MRI-guided biopsy increasingly available, standardize the technique in order to minimize inter-operator variability and depending on the available system.