Cognitive Versus Magnetic Resonance-Ultrasound Fusion Prostate Biopsy: Which One Is Worthier to Perform?

Türkay, Rüştü; İnci, Ercan; Yıldız, Ömer; Ozgur, Eren; Taşçı, Ali İhsan

doi:10.1097/ruq.0000000000000505

Cited by 8 publications

(8 citation statements)

References 19 publications

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“…In 2018, Monda et al, analyzing a series of 510 patients, showed no signi cant difference between the diagnostic ability of cognitive and fusion TBx for detecting csPCa [21]. Similar results were reported by Turkay et al in 2020 in a study comparing men receiving fusion or cognitive TBx [22]. Moreover, Hayes et al observed similar PCa detection rates between fusion and cognitive TBx, except for anteriorly located tumours [23].…”

Section: Discussionmentioning

confidence: 58%

Role of multiparametric magnetic resonance imaging and targeted biopsy in the detection of clinically significant prostate cancer in patients with abnormal digital rectal examination

Giannarini

Ficarra²,

Rossanese³

et al. 2023

Preprint

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Background Few studies examined the role of prostate MRI in patients with abnormal digital rectal examination (DRE) and/or PSA > 10 ng/ml. In a cohort of non-screened patients with abnormal DRE, we investigated the rate of avoidable prostate biopsies and potentially missed clinically significant prostate cancer (csPCa) with negative MRI, and the concordance between targeted biopsy (TBx) and systematic biopsy (SBx) in detecting csPCa with positive MRI.Methods We retrospectively examined 199 biopsy-naïve patients with abnormal DRE who underwent prostate MRI before transperineal biopsy. Prostate Imaging - Reporting And Data System (PI-RADS) v2.1 ≥ 3 category of the index lesion defined a positive MRI. Combined TBx/SBx and SBX alone was performed for positive and negative MRI, respectively. An International Society of Urogenital Pathology Grade Group ≥2 defined csPCa. We calculated csPCa detection rate of TBx, SBx and combined TBx/SBx. The Cohen kappa statistic was used to measure the concordance between TBx and SBx.Results Ninety-one (45.7%) csPCa cases were detected. MRI was positive in 153 (76.9%) patients. In the 46 patients with negative MRI, SBx detected 5 (10.9%) csPCa cases. Prostate biopsy could, thus, be avoided in 41/199 (20.6%) patients at the cost of missing 5/91 (5.5%) csPCa cases. The concordance between TBx and SBx in detecting csPCa with positive mpMRI was substantial (k 0.70). Specifically, 6/86 (6.9%) csPCa cases were detected with TBx, and 17/86 (19.7%) with SBx alone. Concordance was almost perfect (k 0.82) in patients with PSA > 10 ng/ml. Only 4/38 (10.5%) csPCa cases were missed by TBx, and only 1 (2.6%) csPCa case was identified by TBx alone.Conclusion MRI in patients with abnormal DRE could avoid roughly 21% of unnecessary biopsies at the cost of missing approximately 6% of csPCa cases. Moreover, MRI and TBx complemented SBx in detecting csPCa in the subgroup with PSA > 10 ng/ml.

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Section: Discussionmentioning

confidence: 58%

Role of multiparametric magnetic resonance imaging and targeted biopsy in the detection of clinically significant prostate cancer in patients with abnormal digital rectal examination

Giannarini

Ficarra²,

Rossanese³

et al. 2023

Preprint

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“…Regarding the comparison with computerised fusion, several recent studies have shown the superiority of software fusion biopsy over cognitive fusion especially regarding clinically significant cancer [ 29 , 30 ], while other authors could not find any significant difference between the two fusion strategies, especially for larger mpMRI lesions [ 31 , 32 ]. Furthermore, Hamid et al compared the two fusion strategies in the SmartTarget Biopsy Trial and found no difference between them while showing that they should be combined to obtain the best detection rate for clinically significant prostate cancer [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

Transperineal Prostate Biopsy Targeted by Magnetic Resonance Imaging Cognitive Fusion

et al. 2023

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Prostate cancer is among the most frequently diagnosed cancers and a leading cause of cancer-related death in men. Currently, the most reliable and widely used imaging test for prostate cancer diagnosis is multiparametric pelvic magnetic resonance imaging (mpMRI). Modern biopsy techniques are based on the computerised merging of ultrasound and MRI images to provide better vision during the biopsy procedure (Fusion Biopsy). However, the method is expensive due to high equipment cost. Cognitive fusion of ultrasound and MRI images has recently emerged as a cheaper and easier alternative to computerised fusion. The aim of this prospective study is to perform an in-patient comparison of the systematic prostate biopsy procedure (SB) vs. cognitive fusion (CF) guided prostate biopsy method in terms of safety, ease of use, cancer detection rate and clinically significant cancer detection. We enrolled 103 patients with suspected prostate cancer that were biopsy naive, with PSA > 4 ng/dL and PIRADS score of 3, 4 or 5. All patients received a transperineal standard 12–18 cores systematic biopsy (SB) and a four-cores targeted cognitive fusion (CF) biopsy. Following the prostate biopsy, 68% of the patients were diagnosed with prostate cancer (70/103 patients). SB diagnosis rate was 62% while CF biopsy was slightly better with a 66% rate. There was a significant 20% increase in clinically significant prostate cancer detection rate for the CF compared to SB (p < 0.05) and a significant prostate cancer risk upgrade from the low to the intermediate risk category (13%, p = 0.041). Transperineal cognitive fusion targeted prostate biopsy is a straightforward biopsy method that is easy to perform and is a safe alternative to standard systematic biopsy with improved significant cancer detection accuracy. A combined targeted and systematic approach should be used for the best diagnostic results.

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“…Third, we could not analyze the difference according to the type of targeted biopsy (fusion vs. cognitive). There are studies that cognitive biopsy is a reliable technique, and there was no statistical significance in the difference between fusion and cognitive biopsy [ 31 , 32 ]. However, there is also a study that fusion biopsy is superior to cognitive biopsy [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

The Role of Prostate Combination Biopsy Consisting of Targeted and Additional Systematic Biopsy

Lee

Choi

Sung

et al. 2021

JCM

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Background: To identify the role of combination biopsy, which consists of both targeted and additional systematic cores, in the diagnosis of clinically significant prostate cancer (csPCa). Methods: We retrospectively reviewed patients with PSA levels 2.5–15 ng/mL who have a suspicious prostate lesion (with the Prostate Imaging Reporting and Data System (PI-RADS) ≥ 3) on multiparametric MRI (mpMRI) between January 2016 and December 2018. We analyzed biopsy results by PI-RADS score and biopsy methods (systematic, targeted, and combination biopsy). Results: Of the 711 total patients, an average of 4.0 ± 1.8 targeted and 8.6 ± 3.1 additional systematic biopsies were performed. The additional systematic biopsies were sampled outside the targeted biopsy area. The combination biopsies detected more csPCa (201 patients, 28.3%) than did the targeted (175 patients, 24.6%) or systematic (124 patients, 17.4%) biopsies alone (p < 0.001). In the initial biopsy samples, there was a 7% increase in the detection of csPCa than in targeted biopsy (62% to 69%). It increased by 11% in repeat biopsy (46% to 57%). There was no statistical significance in both groups (p = 0.3174). Conclusions: Combination biopsy has the benefit of detecting csPCa in both initial and repeat biopsy when there is a suspicious lesion on mpMRI.

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Cognitive Versus Magnetic Resonance-Ultrasound Fusion Prostate Biopsy: Which One Is Worthier to Perform?

Cited by 8 publications

References 19 publications

Role of multiparametric magnetic resonance imaging and targeted biopsy in the detection of clinically significant prostate cancer in patients with abnormal digital rectal examination

Role of multiparametric magnetic resonance imaging and targeted biopsy in the detection of clinically significant prostate cancer in patients with abnormal digital rectal examination

Transperineal Prostate Biopsy Targeted by Magnetic Resonance Imaging Cognitive Fusion

The Role of Prostate Combination Biopsy Consisting of Targeted and Additional Systematic Biopsy

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