Targeted Prostate Biopsy: How, When, and Why? A Systematic Review

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

Title: Advancements in Targeted Prostate Biopsy Techniques

Summary: The document provides a comprehensive review of the advancements in targeted prostate biopsy techniques, particularly those guided by multiparametric magnetic resonance imaging (mpMRI). It emphasizes the superiority of mpMRI-guided biopsies over traditional 12-core systematic biopsies in detecting clinically significant prostate cancer. The document highlights the benefits of mpMRI in enhancing detection rates, reducing unnecessary biopsies, and minimizing the detection of insignificant cancers. It also discusses the role of artificial intelligence in improving diagnostic accuracy and the economic considerations of adopting advanced diagnostic tools globally. Additionally, the potential of targeted biopsies in active surveillance and the importance of patient-centric approaches, risk assessment, and adherence to evidence-based guidelines are covered.

Strengths:

Comprehensive Review: The document thoroughly covers the advancements in prostate biopsy techniques, providing a detailed comparison between traditional and mpMRI-guided biopsies.

Weaknesses:

Depth of AI Discussion: While the role of artificial intelligence is mentioned, a more in-depth analysis of specific AI applications and their current efficacy could strengthen the review.

 

Overall, the document is a well-structured and informative review of the advancements in targeted prostate biopsy techniques. It effectively highlights the benefits of mpMRI-guided biopsies and provides valuable insights into future directions for prostate cancer diagnosis and management. With some enhancements in the areas of AI applications, economic analysis, and active surveillance, the review could be even more impactful.

 

 

Author Response

Comments:

Title: Advancements in Targeted Prostate Biopsy Techniques

Summary: The document provides a comprehensive review of the advancements in targeted prostate biopsy techniques, particularly those guided by multiparametric magnetic resonance imaging (mpMRI). It emphasizes the superiority of mpMRI-guided biopsies over traditional 12-core systematic biopsies in detecting clinically significant prostate cancer. The document highlights the benefits of mpMRI in enhancing detection rates, reducing unnecessary biopsies, and minimizing the detection of insignificant cancers. It also discusses the role of artificial intelligence in improving diagnostic accuracy and the economic considerations of adopting advanced diagnostic tools globally. Additionally, the potential of targeted biopsies in active surveillance and the importance of patient-centric approaches, risk assessment, and adherence to evidence-based guidelines are covered.

Strengths:

Comprehensive Review: The document thoroughly covers the advancements in prostate biopsy techniques, providing a detailed comparison between traditional and mpMRI-guided biopsies.

Weaknesses:

Depth of AI Discussion: While the role of artificial intelligence is mentioned, a more in-depth analysis of specific AI applications and their current efficacy could strengthen the review.




Overall, the document is a well-structured and informative review of the advancements in targeted prostate biopsy techniques. It effectively highlights the benefits of mpMRI-guided biopsies and provides valuable insights into future directions for prostate cancer diagnosis and management. With some enhancements in the areas of AI applications, economic analysis, and active surveillance, the review could be even more impactful.




Response

Thank you for your comment. We acknowledge that the discussion on artificial intelligence could be explored in more depth. However, the current literature on AI in this context is still evolving, and the available evidence is not yet sufficient to provide a more detailed and conclusive analysis. Our goal was to present a balanced overview of targeted biopsy techniques, focusing on the most robust and well-established advancements without overestimating AI applications that require further research. We will continue to monitor developments in this area to update future reviews accordingly.

Reviewer 2 Report

Comments and Suggestions for Authors

Thank you for sharing your overview and recommendations on the use of targeted prostate biopsies based on abnormal parametric MRI findings compared to conventional systematic biopsies.

With regards to the methodology (according to the PRISMA guideline) the following suggestions:

Kindly elaborate on the methodology with regards to the exact search strategy, outcome definitions, any additional variables used, and any assumptions that were made.

 

The search strategy is not entirely transparent regarding all the databases that were used and includes statements like: “keywords such as “targeted prostate biopsy”, “fusion prostate biopsy”, “cognitive prostate biopsy”, “MRI-guided biopsy”, and “transrectal ultrasound prostate biopsy” were used.

 

Which specific quality assessment tool (“a standardised form”) was used 

to decide on the in- and exclusion of articles?

 

Please elaborate on limitations and any assessments regarding risk of bias. 

 

 

Comments on the Quality of English Language

Good

Author Response

Thank you for sharing your overview and recommendations on the use of targeted prostate biopsies based on abnormal parametric MRI findings compared to conventional systematic biopsies.

With regards to the methodology (according to the PRISMA guideline) the following suggestions:

Kindly elaborate on the methodology with regards to the exact search strategy, outcome definitions, any additional variables used, and any assumptions that were made.

 

The search strategy is not entirely transparent regarding all the databases that were used and includes statements like: “keywords such as “targeted prostate biopsy”, “fusion prostate biopsy”, “cognitive prostate biopsy”, “MRI-guided biopsy”, and “transrectal ultrasound prostate biopsy” were used.

 

Which specific quality assessment tool (“a standardised form”) was used 

to decide on the in- and exclusion of articles?

 

Please elaborate on limitations and any assessments regarding risk of bias. 

Thank you for your valuable feedback.

We have revised the methodology to ensure complete transparency regarding the search strategy. Now, all databases utilized are clearly listed. Additionally, the previously general statements about keywords have been refined to provide a crystal-clear explanation of the specific terms and search strategies employed.

To address your other points:

• We have expanded on the exact search strategy, detailing the outcome definitions, additional variables used, and any assumptions made during the process.
• The specific quality assessment tool used for the inclusion and exclusion of articles is now explicitly mentioned, ensuring clarity on the standardized form employed.
• Finally, we have included a more detailed discussion of the limitations and a thorough assessment of the risk of bias, as per your suggestion.

These changes should enhance the methodological rigor and transparency of the review. Thank you again for your constructive comments