Combined Systematic and MRI-US Fusion Prostate Biopsy Has the Highest Grading Accuracy When Compared to Final Pathology

Andraș, Iulia; Căta, Emanuel Darius; Șerban, Adela; Kadula, Pierre; Telecan, Teodora; Buzoianu, Maximilian; Bungardean, Maria; Stanca, D.; Coman, Ioan; Crişan, Nicolae

doi:10.3390/medicina57060519

Cited by 9 publications

(4 citation statements)

References 41 publications

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“…CF identified four more cancer patients than SB, but the difference was not statistically significant ( p = 0.337). These results are consistent with the findings of other similar studies that found no difference in the overall cancer detection rate between the two methods [ 23 , 24 ]. However, our data showed an important 20% increase in clinically significant cancer detection (Gleason score ≥ 7 or ISUP score ≥ 2) by using cognitive fusion biopsy.…”

Section: Discussionsupporting

confidence: 93%

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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Section: Discussionsupporting

confidence: 93%

Transperineal Prostate Biopsy Targeted by Magnetic Resonance Imaging Cognitive Fusion

et al. 2023

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“…Our results showed that the cutoff values of T2 in the differential diagnosis of prostate transition zone and peripheral zone benign and malignant lesions were 0.840 and 0.796, respectively. For transition zone lesions with T2 ≤ 77 ms or T2 > 77 ms and peripheral zone lesions with T2 ≤ 81 ms or T2 > 81 ms, the single needle PCa biopsy positivity rates for TRUS/MRI fusion‐guided biopsy were significantly higher than those for SB ( p < 0.01), which is in agreement with the results of previous studies 20,21 . However, previous studies have shown conflicting views in terms of the overall detection rate of TRUS/MRI fusion‐guided biopsy and SB for PCa.…”

Section: Discussionsupporting

confidence: 91%

“…For transition zone lesions with T2 ≤ 77 ms or T2 > 77 ms and peripheral zone lesions with T2 ≤ 81 ms or T2 > 81 ms, the single needle PCa biopsy positivity rates for TRUS/MRI fusionguided biopsy were significantly higher than those for SB (p < 0.01), which is in agreement with the results of previous studies. 20,21 However, previous studies have shown conflicting views in terms of the overall detection rate of TRUS/MRI fusion-guided biopsy and SB for PCa. A previous study found that the value of fusion biopsy was greater, 6,22 while another showed that there was no significant difference in the PCa overall detection rate between the two methods.…”

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confidence: 99%

Value of synthetic MRI quantitative parameters in preprocedural evaluation for TRUS/MRI fusion‐guided biopsy of the prostate

Cao

et al. 2023

The Prostate

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Background Transrectal ultrasonography (TRUS)/magnetic resonance imaging (MRI) fusion‐guided biopsy has a high clinical application value. However, this technique has some limitations, which limit its use in routine clinical practice. Therefore, the selection of suitable proatate lesions for this technique is worthy of our attention. Synthetic MRI (SyMRI) is capable of quantifying multiple relaxation parameters, which might have potential value in preprocedural evaluation for TRUS/MRI fusion‐guided biopsy of the prostate. The aim of our study is to examine the value of SyMRI quantitative parameters in preprocedural evaluation for TRUS/MRI fusion‐guided biopsy of the prostate. Methods We prospectively selected 148 lesions in 137 patients who underwent prostate biopsy in our hospital. Next, 2–4 needles of TRUS/MRI fusion‐guided biopsy combined with 10 needles of system biopsy (SB) were used as the protocol for prostate biopsy. Before biopsy, the MAGiC sequences of the MRI images of the enrolled patients underwent post‐processing, and the longitudinal relaxation time (T1), transverse relaxation time (T2), and proton density (PD) were extracted. The biopsy pathology results were used as a gold standard to compare the differences in SyMRI quantitative parameters between benign and malignant prostate lesions in the peripheral and transitional zones. The receiver operating characteristic (ROC) curves were plotted to confirm the optimal SyMRI quantitative parameter for prostate lesion benignancy/malignancy performance, and the cutoff values of these parameters were used for grouping the lesions. The single‐needle biopsy prostate cancer (PCa)‐positivity rates (number of positive biopsy needles/total biopsy needles) and PCa overall detection rates by TRUS/MRI fusion‐guided biopsy and SB were compared in different subgroups. Results The T1 and T2 values can determine the benignancy/malignancy of prostate transition lesions(p < 0.01), and the T2 value has a greater diagnostic performance (p = 0.0376). The T2 value can determine the benignancy/malignancy of prostate peripheral lesions. The optimal diagnostic cutoff values for T2 were 77 and 81 ms, respectively. The single‐needle PCa positivity rate of TRUS/MRI fusion‐guided biopsy was higher than SB for any prostate lesions in different subgroups (p < 0.01). However, only in the subgroup of transition zone lesions with T2 ≤ 77 ms, the PCa overall detection rate of TRUS/MRI fusion‐guided biopsy was significantly higher than that of SB (p = 0.031). Conclusion SyMRI‐T2 value can provide a theoretical basis for the selection of suitable lesions for TRUS/MRI fusion‐guided biopsy.

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“…Limitations of a PM based on a cohort of patients whose pathological specimens were obtained by a surgical approach are the exclusion of patients who underwent radiotherapy, active surveillance, watchful waiting, metastatic patients or refusal of standard of care. However, strengths could be the presence of the histology of the whole prostate gland, as prostate a biopsy may downgrade prostate cancer [65].…”

Section: Discussionmentioning

confidence: 99%

Magnetic Resonance Imaging-Based Predictive Models for Clinically Significant Prostate Cancer: A Systematic Review

Triquell

Campistol

Celma

et al. 2022

Cancers

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MRI can identify suspicious lesions, providing the semi-quantitative risk of csPCa through the Prostate Imaging-Report and Data System (PI-RADS). Predictive models of clinical variables that individualise the risk of csPCa have been developed by adding PI-RADS score (MRI-PMs). Our objective is to analyse the current developed MRI-PMs and define their clinical usefulness. A systematic review was performed after a literature search performed by two independent investigators in PubMed, Cochrane, and Web of Science databases, with the Medical Subjects Headings (MESH): predictive model, nomogram, risk model, magnetic resonance imaging, PI-RADS, prostate cancer, and prostate biopsy. This review was made following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) criteria and studied eligibility based on the Participants, Intervention, Comparator, and Outcomes (PICO) strategy. Among 723 initial identified registers, 18 studies were finally selected. Warp analysis of selected studies was performed with the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. Clinical predictors in addition to the PI-RADS score in developed MRI-PMs were age, PCa family history, digital rectal examination, biopsy status (initial vs. repeat), ethnicity, serum PSA, prostate volume measured by MRI, or calculated PSA density. All MRI-PMs improved the prediction of csPCa made by clinical predictors or imaging alone and achieved most areas under the curve between 0.78 and 0.92. Among 18 developed MRI-PMs, 7 had any external validation, and two RCs were available. The updated PI-RADS version 2 was exclusively used in 11 MRI-PMs. The performance of MRI-PMs according to PI-RADS was only analysed in a single study. We conclude that MRI-PMs improve the selection of candidates for prostate biopsy beyond the PI-RADS category. However, few developed MRI-PMs meet the appropriate requirements in routine clinical practice.

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Combined Systematic and MRI-US Fusion Prostate Biopsy Has the Highest Grading Accuracy When Compared to Final Pathology

Cited by 9 publications

References 41 publications

Transperineal Prostate Biopsy Targeted by Magnetic Resonance Imaging Cognitive Fusion

Transperineal Prostate Biopsy Targeted by Magnetic Resonance Imaging Cognitive Fusion

Value of synthetic MRI quantitative parameters in preprocedural evaluation for TRUS/MRI fusion‐guided biopsy of the prostate

Magnetic Resonance Imaging-Based Predictive Models for Clinically Significant Prostate Cancer: A Systematic Review

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