{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T02:04:31Z","timestamp":1782180271597,"version":"3.54.5"},"reference-count":50,"publisher":"BMJ","issue":"10","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2018,9,20]]},"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To evaluate the feasibility of a novel multiparametric MRI (mpMRI) and cognitive fusion transperineal targeted biopsy (MRTB) led prostate cancer (PCa) diagnostic service with regard to cancer detection and reducing time to diagnosis and treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Consecutive men being investigated for possible PCa under the UK 2-week wait guidelines.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Tertiary referral centre for PCa in the UK.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>Men referred with a raised prostate-specific antigen (PSA) or abnormal digital rectal examination between February 2015 and March 2016 under the UK 2-week rule guideline.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interventions<\/jats:title><jats:p>An mpMRI was performed prior to patients attending clinic, on the same day. If required, MRTB was offered. Results were available within 48\u2009hours and discussed at a specialist multidisciplinary team meeting. Patients returned for counselling within 7 days<\/jats:p><\/jats:sec><jats:sec><jats:title>Primary and secondary outcome measures<\/jats:title><jats:p>Outcome measures in this regard included the time to diagnosis and treatment of patients referred with a suspicion of PCa. Quality control outcome measures included clinically significant and total cancer detection rates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>112 men were referred to the service. 111 (99.1%) underwent mpMRI. Median PSA was 9.4\u2009ng\/mL (IQR 5.6\u201321.0). 87 patients had a target on mpMRI with 25 scoring Likert 3\/5 for likelihood of disease, 26 4\/5 and 36 5\/5.<\/jats:p><jats:p>57 (51%) patients received a local anaesthetic, Magnetic resonance imaging targeted biopsy (MRTB). Cancer was detected in 45 (79%). 43 (96%) had University College London definition 2 disease or greater. The times to diagnosis and treatment were a median of 8 and 20 days, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This approach greatly reduces the time to diagnosis and treatment. Detection rates of significant cancer are high. Similar services may be valuable to patients with a potential diagnosis of PCa.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bmjopen-2018-024941","type":"journal-article","created":{"date-parts":[[2018,10,25]],"date-time":"2018-10-25T08:30:16Z","timestamp":1540456216000},"page":"e024941","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":15,"title":["Prostate cancer diagnostic pathway: Is a one-stop cognitive MRI targeted biopsy service a realistic goal in everyday practice? A pilot cohort in a tertiary referral centre in the UK"],"prefix":"10.1136","volume":"8","author":[{"given":"Edward James","family":"Bass","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Freeman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Jameson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shonit","family":"Punwani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline M","family":"Moore","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manit","family":"Arya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Emberton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1674-6723","authenticated-orcid":false,"given":"Hashim Uddin","family":"Ahmed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,10,24]]},"reference":[{"key":"2024051714554675000_8.10.e024941.1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1113162"},{"key":"2024051714554675000_8.10.e024941.2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2014.55.1192"},{"key":"2024051714554675000_8.10.e024941.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2013.12.062"},{"key":"2024051714554675000_8.10.e024941.4","doi-asserted-by":"crossref","DOI":"10.1148\/radiol.13121501","article-title":"Prostate cancer diagnosis: multiparametric MR-targeted biopsy with cognitive and transrectal US-MR fusion guidance versus systematic biopsy--prospective multicenter study","volume":"268","author":"Puech","year":"2013","journal-title":"Radiology"},{"key":"2024051714554675000_8.10.e024941.5","doi-asserted-by":"publisher","DOI":"10.1002\/pon.1929"},{"key":"2024051714554675000_8.10.e024941.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2012.06.004"},{"key":"2024051714554675000_8.10.e024941.7","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.17942"},{"key":"2024051714554675000_8.10.e024941.8","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1016\/j.eururo.2014.11.037","article-title":"Magnetic resonance imaging-targeted biopsy may enhance the diagnostic accuracy of significant prostate cancer detection compared to standard transrectal ultrasound-guided biopsy: a systematic review and meta-analysis","volume":"68","author":"Schoots","year":"2015","journal-title":"Eur Urol"},{"key":"2024051714554675000_8.10.e024941.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2009.04.102"},{"key":"2024051714554675000_8.10.e024941.10","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2011.08.042"},{"key":"2024051714554675000_8.10.e024941.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2013.03.030"},{"key":"2024051714554675000_8.10.e024941.12","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2010.12.009"},{"key":"2024051714554675000_8.10.e024941.13","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1111\/bju.12892","article-title":"Defining the learning curve for multiparametric magnetic resonance imaging (MRI) of the prostate using MRI-transrectal ultrasonography (TRUS) fusion-guided transperineal prostate biopsies as a validation tool","volume":"117","author":"Gaziev","year":"2016","journal-title":"BJU Int"},{"key":"2024051714554675000_8.10.e024941.14","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2013.12.012"},{"key":"2024051714554675000_8.10.e024941.15","doi-asserted-by":"crossref","unstructured":"Venderink W , van Luijtelaar A , Bomers JG , et al . Results of Targeted Biopsy in Men with Magnetic Resonance Imaging Lesions Classified Equivocal, Likely or Highly Likely to Be Clinically Significant Prostate Cancer. Eur Urol 2017.doi:10.1016\/j.eururo.2017.02.021","DOI":"10.1016\/j.eururo.2017.02.021"},{"key":"2024051714554675000_8.10.e024941.16","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1016\/j.urology.2015.07.001","article-title":"Targeted prostate biopsy: lessons learned midst the evolution of a disruptive technology","volume":"86","author":"Nassiri","year":"2015","journal-title":"Urology"},{"key":"2024051714554675000_8.10.e024941.17","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2014.03.002"},{"key":"2024051714554675000_8.10.e024941.18","doi-asserted-by":"crossref","first-page":"1767","DOI":"10.1056\/NEJMoa1801993","article-title":"MRI-targeted or standard biopsy for prostate-cancer diagnosis","volume":"378","author":"Kasivisvanathan","year":"2018","journal-title":"N Engl J Med"},{"key":"2024051714554675000_8.10.e024941.19","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-011-2377-y"},{"key":"2024051714554675000_8.10.e024941.20","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2012.10.009"},{"key":"2024051714554675000_8.10.e024941.21","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2015.01.013"},{"key":"2024051714554675000_8.10.e024941.22","doi-asserted-by":"publisher","DOI":"10.1002\/jmri.23689"},{"key":"2024051714554675000_8.10.e024941.23","doi-asserted-by":"crossref","first-page":"1016","DOI":"10.1016\/j.crad.2013.03.030","article-title":"Prostate MRI: who, when, and how? Report from a UK consensus meeting","volume":"68","author":"Kirkham","year":"2013","journal-title":"Clin Radiol"},{"key":"2024051714554675000_8.10.e024941.24","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.12.10173"},{"key":"2024051714554675000_8.10.e024941.25","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1038\/pcan.2017.13","article-title":"Magnetic resonance imaging targeted transperineal prostate biopsy: a local anaesthetic approach","volume":"20","author":"Bass","year":"2017","journal-title":"Prostate Cancer Prostatic Dis"},{"key":"2024051714554675000_8.10.e024941.26","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2011.03.147"},{"key":"2024051714554675000_8.10.e024941.27","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2003.10.014"},{"key":"2024051714554675000_8.10.e024941.28","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(01)68188-6"},{"key":"2024051714554675000_8.10.e024941.29","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(01)63951-X"},{"key":"2024051714554675000_8.10.e024941.30","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/S0022-5347(06)00493-9","article-title":"Impact of increased number of biopsies on the nature of prostate cancer identified","volume":"176","author":"Meng","year":"2006","journal-title":"J Urol"},{"key":"2024051714554675000_8.10.e024941.31","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djm153"},{"key":"2024051714554675000_8.10.e024941.32","first-page":"3866","article-title":"The worldwide epidemiology of prostate cancer: perspectives from autopsy studies","volume":"15","author":"Haas","year":"2008","journal-title":"Can J Urol"},{"key":"2024051714554675000_8.10.e024941.33","doi-asserted-by":"crossref","first-page":"e13257","DOI":"10.5812\/iranjradiol.13257","article-title":"Prostate biopsy using transrectal ultrasonography; the optimal number of cores regarding cancer detection rate and complications","volume":"12","author":"Ghafoori","year":"2015","journal-title":"Iran J Radiol"},{"key":"2024051714554675000_8.10.e024941.34","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2012.04.044"},{"key":"2024051714554675000_8.10.e024941.35","doi-asserted-by":"crossref","first-page":"1199","DOI":"10.1007\/s00345-016-1985-1","article-title":"Zero hospital admissions for infection after 577 transperineal prostate biopsies using single-dose cephazolin prophylaxis","volume":"35","author":"Pepdjonovic","year":"2017","journal-title":"World J Urol"},{"key":"2024051714554675000_8.10.e024941.36","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2013.05.049"},{"key":"2024051714554675000_8.10.e024941.37","doi-asserted-by":"publisher","DOI":"10.1038\/pcan.2013.43"},{"key":"2024051714554675000_8.10.e024941.38","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)32401-1"},{"key":"2024051714554675000_8.10.e024941.39","unstructured":"Mottet N , Bellmunt J , Briers E , et al . EAU \u2013 ESTRO \u2013 SIOG Guidelines on Prostate Cancer. https:\/\/uroweb.org\/wp-content\/uploads\/EAU-Guidelines-Prostate-Cancer-2016.pdf (Accessed 8th Feb 2018)."},{"key":"2024051714554675000_8.10.e024941.40","unstructured":"National Institute of Clinical Excellence. Prostate cancer: diagnosis and management 2014. https:\/\/www.nice.org.uk\/guidance\/cg175\/chapter\/1-recommendations#assessment-2 (Accessed 8thFebruary 2018)."},{"key":"2024051714554675000_8.10.e024941.41","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2015.08.038"},{"key":"2024051714554675000_8.10.e024941.42","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2014.10.026"},{"key":"2024051714554675000_8.10.e024941.43","doi-asserted-by":"crossref","first-page":"884","DOI":"10.1002\/cncr.29874","article-title":"Prostate cancer detection with magnetic resonance-ultrasound fusion biopsy: The role of systematic and targeted biopsies","volume":"122","author":"Filson","year":"2016","journal-title":"Cancer"},{"key":"2024051714554675000_8.10.e024941.44","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.14.12681"},{"key":"2024051714554675000_8.10.e024941.45","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1016\/j.eururo.2016.07.041","article-title":"Comparing three different techniques for magnetic resonance imaging-targeted prostate biopsies: a systematic review of in-bore versus magnetic resonance imaging-transrectal ultrasound fusion versus cognitive registration. is there a preferred technique?","volume":"71","author":"Wegelin","year":"2017","journal-title":"Eur Urol"},{"key":"2024051714554675000_8.10.e024941.46","doi-asserted-by":"crossref","first-page":"1978","DOI":"10.1016\/j.juro.2013.08.050","article-title":"MRI before prostate biopsy--yes or no?","volume":"190","author":"Albertsen","year":"2013","journal-title":"J Urol"},{"key":"2024051714554675000_8.10.e024941.47","doi-asserted-by":"crossref","first-page":"119.e1","DOI":"10.1016\/j.urolonc.2015.09.010","article-title":"Cost-effectiveness of multiparametric magnetic resonance imaging and targeted biopsy in diagnosing prostate cancer","volume":"34","author":"Cerantola","year":"2016","journal-title":"Urol Oncol"},{"key":"2024051714554675000_8.10.e024941.48","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.eururo.2017.08.018","article-title":"Optimising the diagnosis of prostate cancer in the era of multiparametric magnetic resonance imaging: a cost-effectiveness analysis based on the Prostate MR Imaging Study (PROMIS)","volume":"73","author":"Faria","year":"2018","journal-title":"Eur Urol"},{"key":"2024051714554675000_8.10.e024941.49","unstructured":"England NHS . Waiting Times for Suspected and Diagnosed Cancer Patients: 2016\/17 Annual Report. https:\/\/www.england.nhs.uk\/statistics\/wp-content\/uploads\/sites\/2\/2017\/06\/Cancer-Waiting-Times-Annual-Report-201617-1.pdf (Accessed 21st Dec 2017)."},{"key":"2024051714554675000_8.10.e024941.50","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.195.2.7724756"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2018-024941","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,18]],"date-time":"2024-05-18T01:59:38Z","timestamp":1715997578000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2018-024941"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,10]]},"references-count":50,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2018,10,24]]},"published-print":{"date-parts":[[2018,10]]}},"alternative-id":["10.1136\/bmjopen-2018-024941"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2018-024941","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,10]]}}}