Characterizing Clinically Significant Prostate Cancer Using Template Prostate Mapping Biopsy

Ahmed, Hashim U.; Hu, Yipeng; Carter, Tim; Arumainayagam, Nimalan; Lecornet, Emilie; Freeman, Alex; Hawkes, David J.; Barratt, Dean C.; Emberton, Mark

doi:10.1016/j.juro.2011.03.147

Cited by 254 publications

(189 citation statements)

References 20 publications

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“…When prostatectomy was not performed, clinical significance of prostate cancer was defined by: 1) a PSA >10 ng/mL and a PSA density >0.15 ng/mL per mL; 2) clinical stage ≥T2b; 3) a Gleason grade 4 or 5 within the biopsy specimen; 4) >2 positive cores with >30% involvement in each core. For in-bore biopsies the criteria for clinical significance were as follows; 1) a PSA >10 ng/mL and a PSA density >0.15 ng/mL per mL; 2) clinical stage ≥T2b; 3) a Gleason grade 4 or 5 within the biopsy specimen; 4) a total cancer-core length ≥10 mm (8)(9)(10)(11). In case of performed prostatectomy, prostate cancer was considered clinically significant when prostate cancer volume was ≥0.5 mL or a stage ≥pT3 or a Gleason grade 4 or 5 was present (12,13).…”

Section: Correlation Of Mri and Biopsymentioning

confidence: 99%

Multiparametric MRI guidance in first-time prostate biopsies: what is the real benefit?

Acar

Esen²,

Çolakoğlu³

et al. 2015

Diagn Interv Radiol

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Section: Correlation Of Mri and Biopsymentioning

confidence: 99%

Multiparametric MRI guidance in first-time prostate biopsies: what is the real benefit?

Acar

Esen²,

Çolakoğlu³

et al. 2015

Diagn Interv Radiol

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“…However, transperineal biopsies can be performed in a number of different ways with varying biopsy densities. These can generally be categorised into those that first, map the prostate by taking biopsies every 5mm [8][9][10][11] or second, those that sample regions of the prostate but with reduced density of cores [12][13][14][15]. Whilst computer simulation studies demonstrate less sensitivity in detecting lesions that are >0.5cc or >0.2cc in volume when using a 10mm sampling frame compared to taking biopsies every 5mm [16], it is not known whether this is the case in patients.…”

Section: Introductionmentioning

confidence: 99%

Transperineal template prostate‐mapping biopsies: an evaluation of different protocols in the detection of clinically significant prostate cancer

et al. 2015

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ObjectivesTo determine whether modified transperineal template prostate mapping (TTPM) biopsy protocols, altering the template or the biopsy density, have sensitivity and negative predictive value equal to full 5mm TTPM. Materials and MethodsRetrospective analysis of an institutional registry including treatment-naïve men undergoing 5mm TTPM analysed in 20 zones fashion. The value of three modified strategies was assessed by comparing the information provided by selected zones against full 5mm TTPM.Strategy 1 did not consider the findings of anterior areas; strategies 2 and 3 simulated a reduced biopsy density by excluding intervening zones. A bootstrapping technique was employed to calculate reliable estimates of sensitivity and negative predictive value of these three strategies with respect to detection of clinically significant disease (maximum cancer core length >/= 4mm and/or Gleason score >/= 3+4).Results 391 men with median age 62 years (IQR 58-67) were included. Median PSA and PSA density were 6.9 ng/ml (IQR 4.8-10) and 0.17 (IQR 0.12-0.25), respectively. A median of 6 cores (IQR 2-9) out of 48 taken per man (IQR 33-63) were positive for prostate cancer. No cancer was detected in 67 men (17%), whilst low, intermediate and high risk disease was identified in 78 (20%), 80 (21%) and 166 (42%), respectively. Strategy 1, 2 and 3 had sensitivities of 78% (95% CI 73-84%), 85% (95% CI 80-90%) and 84% (95% CI 79-89%), respectively. The negative predictive values of the three strategies was at 73% (95% CI 67-80%), 80% (95% CI 74-86%) and 79% (95% CI 72-84%), respectively. ConclusionAltering the template or decreasing sampling density has a substantial negative impact on the ability of TTPM to rule out clinically significant disease. This should be considered when modified TTPM strategies are performed to select men for tissue-preserving approaches, and when modified TTPM are employed to validate new diagnostic tests.

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“…Overall cancer detection rates were determined as was the rates of detection for measures of clinically significant disease using a number of thresholds. The definition of disease according to the UCL criteria for clinical significance developed for transperineal biopsies were used 13 . Definition 1 was the presence of Gleason ≥4+3 and/or maximum cancer core length ≥6mm and definition 2 was the presence of Gleason ≥3+4 and/or maximum cancer core length ≥4mm.…”

mentioning

confidence: 99%

Magnetic resonance imaging targeted transperineal prostate biopsy: a local anaesthetic approach

Bass

Donaldson

Freeman

et al. 2017

Prostate Cancer Prostatic Dis

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Characterizing Clinically Significant Prostate Cancer Using Template Prostate Mapping Biopsy

Abstract: Transperineal prostate mapping may provide an effective method to risk stratify men with localized prostate cancer. The definitions that we present require prospective validation.

Cited by 254 publications

References 20 publications

Multiparametric MRI guidance in first-time prostate biopsies: what is the real benefit?

Multiparametric MRI guidance in first-time prostate biopsies: what is the real benefit?

Transperineal template prostate‐mapping biopsies: an evaluation of different protocols in the detection of clinically significant prostate cancer

Magnetic resonance imaging targeted transperineal prostate biopsy: a local anaesthetic approach

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