De FUTURE trial; een multicenter RCT naar MRI-geleide prostaatbiopten: Vergelijking van drie technieken van target biopten en vergelijking met systematische biopten

Abstract

The FUTURE trial is a multicenter RCT on 3 MRI-based target biopsy (TB) techniques among patients with negative systematic biopsies (SBs) and persisting suspicion of prostate cancer. Between 2014 and 2017 665 patients underwent multiparametric MRI. 234 (35%) patients with a PIRADS ≥3 lesion were randomised 1:1:1 for TB: in-bore MRI (MRI-TB), MRI/ultrasound fusion (FUS-TB), and cognitive fusion (COG-TB). After FUS-TB and COG-TB additional SB was performed. No significant differences in prostate cancer detection and significant prostate cancer were found (MRI-TB 54.5%/32.5%, FUS-TB 49.4%/34.2%, and COG-TB 43.6%/33.3%, p = 0.39/p = 0.98). Combined SBs and TBs versus TBs alone resulted in 1% more csPCa detection (35% vs 34%). There was no significant advantage of one TB technique for the detection of overall prostate cancer, nor for clinically significant prostate cancer. The additional value of SBs was limited.