TY - JOUR TI - Micro-Ultrasound-Guided vs Multiparametric Magnetic Resonance Imaging-Targeted Biopsy in the Detection of Prostate Cancer: A Systematic Review and Meta-Analysis AU - Sountoulides, P. AU - Pyrgidis, N. AU - Polyzos, S.A. AU - Mykoniatis, I. AU - Asouhidou, E. AU - Papatsoris, A. AU - Dellis, A. AU - Anastasiadis, A. AU - Lusuardi, L. AU - Hatzichristou, D. JO - The Journal of Urology PY - 2021 VL - 205 TODO - 5 SP - 1254-1262 PB - NLM (Medline) SN - 0022-5347, 1527-3792 TODO - 10.1097/JU.0000000000001639 TODO - comparative study; human; image guided biopsy; interventional ultrasonography; male; meta analysis; multiparametric magnetic resonance imaging; pathology; procedures; prostate; prostate tumor, Humans; Image-Guided Biopsy; Male; Multiparametric Magnetic Resonance Imaging; Prostate; Prostatic Neoplasms; Ultrasonography, Interventional TODO - PURPOSE: Micro-ultrasound is a novel high resolution ultrasound technology aiming to improve prostate imaging and, consequently, the diagnostic accuracy of ultrasound-guided prostate biopsy. Micro-ultrasound-guided prostate biopsy may present comparable detection rates to the standard of care multiparametric magnetic resonance imaging-targeted prostate biopsy for the diagnosis of clinically significant prostate cancer. We aimed to compare the detection rate of micro-ultrasound vs multiparametric magnetic resonance imaging-targeted prostate biopsy for prostate cancer diagnosis. MATERIALS AND METHODS: We performed a systematic review and meta-analysis of diagnostic accuracy studies comparing micro-ultrasound-guided prostate biopsy to multiparametric magnetic resonance imaging-targeted prostate biopsy as a reference standard test (PROSPERO ID: CRD42020198326). Records were identified by searching in PubMed®, Scopus® and Cochrane Library databases, as well as in potential sources of gray literature until November 30th, 2020. RESULTS: We included 18 studies in the qualitative and 13 in the quantitative synthesis. In the quantitative synthesis, 1,125 participants received micro-ultrasound-guided followed by multiparametric magnetic resonance imaging-targeted and systematic prostate biopsy. Micro-ultrasound and multiparametric magnetic resonance imaging-targeted prostate biopsies displayed similar detection rates across all prostate cancer grades. The pooled detection ratio for International Society of Urological Pathology Grade Group ≥2 prostate cancer was 1.05 (95% CI 0.93-1.19, I2=0%), 1.25 (95% CI 0.95-1.64, I2=0%) for Grade Group ≥3 and 0.94 (95% CI 0.73-1.22, I2=0%) for clinically insignificant (Grade Group 1) prostate cancer. The overall detection ratio for prostate cancer was 0.99 (95% CI 0.89-1.11, I2=0%). CONCLUSIONS: Micro-ultrasound-guided prostate biopsy provides comparable detection rates for prostate cancer diagnosis with the multiparametric magnetic resonance imaging-guided prostate biopsy. Therefore, it could be considered as an attractive alternative to multiparametric magnetic resonance imaging-targeted prostate biopsy. Nevertheless, high quality randomized trials are warranted to corroborate our findings. ER -