A Comparative Study of Prostate Cancer Detection Rate Between Transperineal COG-TB and Transperineal FUS-TB in Patients with PSA ≤20 ng/mL

Abstract

Background: The combination of prebiopsy MRI and transperineal targeted biopsies is being increasingly used to obtain tissues from patients with suspected prostate cancer (PCa). Objective: To investigate the difference in PCa detection rate between transperineal cognitive fusion TB (COG-TB) and transperineal software fusion TB (FUS-TB). Participants: The present study included 163 male patients with suspected PCa who had not undergone prostate biopsy, had a prostate-specific antigen (PSA) level of £20 ng/mL, and had been examined by bi-parameter MRI and confirmed to have prostate nodules by prostate imaging reporting and data system version 2 (PI-RADS V2) scores ‡3 (from December 3, 2018 to October 7, 2019). Intervention: Seventy-one patients underwent transperineal COG-TB, and 92 patients underwent transperineal FUS-TB. The detection rate of the first four needles was compared. Results: No significant difference was found in the overall detection rate of PCa between COG-TB and FUS-TB (60.56% vs 51.08%, p = 0.228). This result was consistent even after stratifying by PI-RADS score. There was also no significant difference between COG-TB and FUS-TB in the detection rate of clinically significant PCa (p = 0.641). Moreover, COG-TB and FUS-TB showed no difference in the detection rate of PCa with different Gleason scores. Conclusions: In patients with suspected PCa with PSA £20 ng/mL and PI-RADS ‡3, FUS-TB was comparable to COG-TB in the detection rate of PCa.

Clinical value of minimum apparent diffusion coefficient for prediction of clinically significant prostate cancer in the transition zone

“…Regarding limitations, the possibility of sampling errors in targeted biopsies must be considered. The cancer detection rate by transperineal cognitive fusion targeted biopsy for lesions classified as PI-RADS 3 or greater has been reported to be 66.3-75% [23][24][25]. Our cancer detection rate of 49% for PI-RADS category 4/5 lesions seems to be relatively low, although there might be a subset of patients with falsepositive results in the PI-RADS assessment in the present study.…”

Transperineal US-MRI Fusion-Guided Biopsy for the Detection of Clinical Significant Prostate Cancer: A Systematic Review and Meta-Analysis Comparing Cognitive and Software-Assisted Technique

“…The remaining 13 full-text papers were assessed for eligibility and 5 studies were excluded. Finally, 8 papers were accepted and included [ 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 ]. Figure 1 shows the flow diagram of the literature search.…”

“…Table 1 shows the characteristics of the included studies. There were three retrospective [ 16 , 17 , 20 ] and five prospective studies [ 18 , 19 , 21 , 22 , 23 ]. Among the latter, one study had a within-person randomization protocol [ 21 ].…”

“…Among the latter, one study had a within-person randomization protocol [ 21 ]. There were five studies comparing the software-based versus the cognitive fusion technique between patients [ 16 , 17 , 18 , 19 , 20 ], while a comparison was performed within person in the remaining ones [ 21 , 22 , 23 ].…”

“… Meta-analysis of clinically significant prostate cancer detection rates in targeted lesions [ 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 ]. …”