Cognitive zonal fusion biopsy of the prostate: Original technique between target and saturation

Galosi, Andrea Benedetto; Maselli, Guevar; Sbrollini, Giulia; Donatelli, Gaetano; Montesi, Lorenzo; Tallè, Matteo; Montironi, Rodolfo

doi:10.4081/aiua.2016.4.292

Cited by 10 publications

(14 citation statements)

References 5 publications

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“…Compared to standard TRUS sampling and MRI–US fusion targeted biopsy, evidence demonstrates saturation biopsy (24 or 30 core templated sampling) provides the greatest sensitivity for detection of significant PCa in the initial AS period ( 45 – 47 ). While this approach may provide enhanced detection, it also subjects patients to the burden of increased tissue acquisition.…”

Section: Resultsmentioning

confidence: 99%

“…When prostate biopsy is indicated, the integration of MRI technology with TRUS biopsy via MRI–US fusion technology enhances the ability to sample concerning lesions with pinpoint accuracy ( 39 – 42 ). Recent evidence suggests that performing MRI-targeted biopsies may be just as reliable as saturation biopsies for detection of significant PCa ( 45 – 47 ). This would spare both patients and providers the burden of acquiring unnecessary cores, and may lessen the frequency of detecting insignificant disease ( 46 ).…”

Section: Discussionmentioning

confidence: 99%

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Prostate Cancer Imaging and Biomarkers Guiding Safe Selection of Active Surveillance

et al. 2017

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BackgroundActive surveillance (AS) is a widely adopted strategy to monitor men with low-risk, localized prostate cancer (PCa). Current AS inclusion criteria may misclassify as many as one in four patients. The advent of multiparametric magnetic resonance imaging (mpMRI) and novel PCa biomarkers may offer improved risk stratification. We performed a review of recently published literature to characterize emerging evidence in support of these novel modalities.MethodsAn English literature search was conducted on PubMed for available original investigations on localized PCa, AS, imaging, and biomarkers published within the past 3 years. Our Boolean criteria included the following terms: PCa, AS, imaging, biomarker, genetic, genomic, prospective, retrospective, and comparative. The bibliographies and diagnostic modalities of the identified studies were used to expand our search.ResultsOur review identified 222 original studies. Our expanded search yielded 244 studies. Among these, 70 met our inclusion criteria. Evidence suggests mpMRI offers improved detection of clinically significant PCa, and MRI-fusion technology enhances the sensitivity of surveillance biopsies. Multiple studies demonstrate the promise of commercially available screening assays for prediction of AS failure, and several novel biomarkers show promise in this setting.ConclusionIn the era of AS for men with low-risk PCa, improved strategies for proper stratification are needed. mpMRI has dramatically enhanced the detection of clinically significant PCa. The advent of novel biomarkers for prediction of aggressive disease and AS failure has shown some initial promise, but further validation is warranted.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Prostate Cancer Imaging and Biomarkers Guiding Safe Selection of Active Surveillance

et al. 2017

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“…Of all of the prostate biopsy modalities, there is strong evidence in support of saturation biopsy (24 or 30 cores templated sampling) as the technique with greatest sensitivity for detecting significant PCa in the initial AS period ( 58 - 60 ). However, it subjects patients to the burden of acquiring a significant amount of tissue, and may not reliably predict the location or extent of disease on pathology following radical prostatectomy ( 61 ).…”

Section: Prostate Biopsy In the Era Of Mri-us Fusionmentioning

confidence: 99%

“…However, it subjects patients to the burden of acquiring a significant amount of tissue, and may not reliably predict the location or extent of disease on pathology following radical prostatectomy ( 61 ). Alternatively, Galosi et al proposed a hybrid approach to saturation biopsy called ‘cognitive zonal fusion biopsy’ ( 60 ). For this, patients undergo mpMRI prior to fusion biopsy.…”

Section: Prostate Biopsy In the Era Of Mri-us Fusionmentioning

confidence: 99%

“…If during the biopsy there is a discrepancy between what was found on MRI and what is seen on US, several cores are obtained from the MRI region of interest. This approach reliably detected csPCa in their prospective study of 58 men who were either biopsy naïve, had a prior negative biopsy, or were on AS ( 60 ). In a study of 48 men on AS with prior negative TRUS biopsy, Lai et al also achieved satisfactory PCa detection using this technique ( 62 ).…”

Section: Prostate Biopsy In the Era Of Mri-us Fusionmentioning

confidence: 99%

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MRI findings guiding selection of active surveillance for prostate cancer: a review of emerging evidence

Glaser¹,

Porter²,

Thomas³

et al. 2018

Transl. Androl. Urol.

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Active surveillance (AS) for prostate cancer (PCa) is generally considered to be a safe strategy for men with low-risk, localized disease. However, as many as 1 in 4 patients may be incorrectly classified as AS-eligible using traditional inclusion criteria. The use of multiparametric magnetic resonance imaging (mpMRI) may offer improved risk stratification in both the initial diagnostic and disease monitoring setting. We performed a review of recently published studies to evaluate the utility of this imaging modality for this clinical setting. An English literature search was conducted on PubMed for original investigations on localized PCa, AS, and magnetic resonance imaging. Our Boolean criteria included the following terms: PCa, AS, imaging, MRI, mpMRI, prospective, retrospective, and comparative. Our search excluded publication types such as comments, editorials, guidelines, reviews, or interviews. Our literature review identified 71 original investigations. Among these, 52 met our inclusion criteria. Evidence suggests mpMRI improves characterization of clinically significant prostate cancer (csPCa) foci, and the enhanced detection and risk-stratification afforded by this modality may keep men from being inappropriately placed on AS. Use of serial mpMRI may also permit longer intervals between confirmatory biopsies. Multiple studies demonstrate the benefit of MRI-targeted biopsies. The use of mpMRI of the prostate offers improved confidence in risk-stratification for men with clinically low-risk PCa considering AS. While on AS, serial mpMRI and MRI-targeted biopsy aid in the detection of aggressive disease transformation or foci of clinically-significant cancer undetected on prior biopsy sessions.

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Diagnostic Performance of a Magnetic Resonance Imaging-directed Targeted plus Regional Biopsy Approach in Prostate Cancer Diagnosis: A Systematic Review and Meta-analysis

Hagens

Salamanca

Padhani

et al. 2022

European Urology Open Science

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Cognitive zonal fusion biopsy of the prostate: Original technique between target and saturation

Cited by 10 publications

References 5 publications

Prostate Cancer Imaging and Biomarkers Guiding Safe Selection of Active Surveillance

Prostate Cancer Imaging and Biomarkers Guiding Safe Selection of Active Surveillance

MRI findings guiding selection of active surveillance for prostate cancer: a review of emerging evidence

Diagnostic Performance of a Magnetic Resonance Imaging-directed Targeted plus Regional Biopsy Approach in Prostate Cancer Diagnosis: A Systematic Review and Meta-analysis

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