title: Standards of reporting for MRI-targeted biopsy studies (START) of the prostate: recommendations from an International Working Group.
abstract: BACKGROUND
  A systematic literature review of magnetic resonance imaging (MRI)-targeted prostate biopsy demonstrates poor adherence to the Standards for the Reporting of Diagnostic Accuracy (STARD) recommendations for the full and transparent reporting of diagnostic studies.
  
  
  OBJECTIVE
  To define and recommend Standards of Reporting for MRI-targeted Biopsy Studies (START).
  
  
  METHODS
  Each member of a panel of 23 experts in urology, radiology, histopathology, and methodology used the RAND/UCLA appropriateness methodology to score a 258-statement premeeting questionnaire. The collated responses were presented at a face-to-face meeting, and each statement was rescored after group discussion.
  
  
  METHODS
  Measures of agreement and consensus were calculated for each statement. The most important statements, based on group median score, the degree of group consensus, and the content of the group discussion, were used to create a checklist of reporting criteria (the START checklist).
  
  
  CONCLUSIONS
  The strongest recommendations were to report histologic results of standard and targeted cores separately using Gleason score and maximum cancer core length. A table comparing detection rates of clinically significant and clinically insignificant disease by targeted and standard approaches should also be used. It was recommended to report the recruitment criteria for MRI-targeted biopsy, prior biopsy status of the population, a brief description of the MRI sequences, MRI reporting method, radiologist experience, and image registration technique. There was uncertainty about which histologic criteria constitute clinically significant cancer when the prostate is sampled using MRI-targeted biopsy, and it was agreed that a new definition of clinical significance in this setting needed to be derived in future studies.
  
  
  CONCLUSIONS
  Use of the START checklist would improve the quality of reporting in MRI-targeted biopsy studies and facilitate a comparison between standard and MRI-targeted approaches.
authors.affiliation: Division of Surgical and Interventional Sciences, University College London, London, UK. carolinemoore@doctors.org.uk
authors.forename: Caroline M
authors.initials: CM
authors.lastname: Moore
authors.forename: Veeru
authors.initials: V
authors.lastname: Kasivisvanathan
authors.forename: Scott
authors.initials: S
authors.lastname: Eggener
authors.forename: Mark
authors.initials: M
authors.lastname: Emberton
authors.forename: Jurgen J
authors.initials: JJ
authors.lastname: Fütterer
authors.forename: Inderbir S
authors.initials: IS
authors.lastname: Gill
authors.forename: Robert L
authors.initials: RL
authors.lastname: Grubb Iii
authors.forename: Boris
authors.initials: B
authors.lastname: Hadaschik
authors.forename: Laurence
authors.initials: L
authors.lastname: Klotz
authors.forename: Daniel J A
authors.initials: DJ
authors.lastname: Margolis
authors.forename: Leonard S
authors.initials: LS
authors.lastname: Marks
authors.forename: Jonathan
authors.initials: J
authors.lastname: Melamed
authors.forename: Aytekin
authors.initials: A
authors.lastname: Oto
authors.forename: Suzanne L
authors.initials: SL
authors.lastname: Palmer
authors.forename: Peter
authors.initials: P
authors.lastname: Pinto
authors.forename: Philippe
authors.initials: P
authors.lastname: Puech
authors.forename: Shonit
authors.initials: S
authors.lastname: Punwani
authors.forename: Andrew B
authors.initials: AB
authors.lastname: Rosenkrantz
authors.forename: Ivo G
authors.initials: IG
authors.lastname: Schoots
authors.forename: Richard
authors.initials: R
authors.lastname: Simon
authors.forename: Samir S
authors.initials: SS
authors.lastname: Taneja
authors.forename: Baris
authors.initials: B
authors.lastname: Turkbey
authors.forename: Osamu
authors.initials: O
authors.lastname: Ukimura
authors.forename: Jan
authors.initials: J
authors.lastname: van der Meulen
authors.forename: Arnauld
authors.initials: A
authors.lastname: Villers
authors.forename: Yuji
authors.initials: Y
authors.lastname: Watanabe
mesh_terms: D057189:Checklist / Q000592:standards; D032921:Consensus; D019983:Guideline Adherence / Q000592:standards; D006801:Humans; D061705:Image-Guided Biopsy / Q000592:standards*; D053783:Magnetic Resonance Imaging, Interventional / Q000592:standards*; D008297:Male; D010818:Practice Patterns, Physicians' / Q000592:standards; D011237:Predictive Value of Tests; D011379:Prognosis; D011467:Prostate / Q000473:pathology*; D011471:Prostatic Neoplasms / Q000473:pathology*; D012107:Research Design / Q000592:standards*; D014572:Urology / Q000592:standards*
keywords: Diagnosis; Magnetic resonance imaging; Prostate cancer; Registration; Reporting standards; Targeted biopsy