Magnetic Resonance Imaging–guided In-bore and Magnetic Resonance Imaging-transrectal Ultrasound Fusion Targeted Prostate Biopsies: An Adjusted Comparison of Clinically Significant Prostate Cancer Detection Rate

Costa, Daniel N.; Goldberg, Kenneth; Leon, Alberto Diaz de; Lotan, Yair; Xi, Yin; Aziz, Muhammad Usman; Freifeld, Yuval; Margulis, Vitaly; Raj, Ganesh V.; Roehrborn, Claus G.; Hornberger, Brad; Desai, Neil B.; Bagrodia, Aditya; Francis, Franto; Pedrosa, Iván; Cadeddu, Jeffrey A.

doi:10.1016/j.euo.2018.08.022

Cited by 48 publications

(30 citation statements)

References 18 publications

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“…The difference in csPCa detection between FUS-TB and IB-TB was explored in a retrospective analysis, demonstrating no significant difference in csPCa detection rate with 49% in the FUS-TB group and 61% in the IB-TB group. These results are in contrast to a later study which also compared csPCa detection between 300 FUS-TB and 103 IB-TB patients [34], which found that IB-TB led to a higher rate of csPCa detection and lower rate of ciPCa detection, as well as less frequent GG upgrading on prostatectomy. Another prospective trial randomized 210 men with at least one prior negative prostate biopsy.…”

Section: In-bore Versus Cognitive Fusion Versus Software-guided Fusiocontrasting

confidence: 99%

Comparative Effectiveness of Techniques in Targeted Prostate Biopsy

Sugano

Kaneko

Yip

et al. 2021

Cancers

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In this review, we evaluated literature regarding different modalities for multiparametric magnetic resonance imaging (mpMRI) and mpMRI-targeted biopsy (TB) for the detection of prostate cancer (PCa). We identified studies evaluating systematic biopsy (SB) and TB in the same patient, thereby allowing each patient to serve as their own control. Although the evidence supports the accuracy of TB, there is still a proportion of clinically significant PCa (csPCa) that is detected only in SB, indicating the importance of maintaining SB in the diagnostic pathway, albeit with additional cost and morbidity. There is a growing subset of data which supports the role of TB alone, which may allow for increased efficiency and decreased complications. We also compared the literature on transrectal (TR) vs. transperineal (TP) TB. Although further high-level evidence is necessary, current evidence supports similar csPCa detection rate for both approaches. We also evaluated various TB techniques such as cognitive fusion biopsy (COG-TB) and in-bore biopsy (IB-TB). COG-TB has comparable detection rates to software fusion, but is operator-dependent and may have reduced accuracy for smaller lesions. IB-TB may allow for greater precision as lesions are directly targeted; however, this is costly and time-consuming, and does not account for MRI-invisible lesions.

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Section: In-bore Versus Cognitive Fusion Versus Software-guided Fusiocontrasting

confidence: 99%

Comparative Effectiveness of Techniques in Targeted Prostate Biopsy

Sugano

Kaneko

Yip

et al. 2021

Cancers

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“…the study given relatively small numbers in the two cohorts. Conversely, Venderink et al [12] found the positive biopsy rate was significantly higher for any cancer detected by in-bore biopsy (85%; 193/227 patients) compared to fusion (67%; 34/51), and Costa et al [13] found the clinically significant prostate cancer detection rate was significantly higher for in-bore (61%; 63/103) than for fusion (47%; 141/300). The superiority of the in-bore approach in these two studies aligns with our findings.…”

Section: Accepted Manuscriptmentioning

confidence: 96%

“…Despite the important developments favoring MRI-targeted biopsy over systematic biopsy, few studies have directly compared in-bore and fusion MRItargeted biopsy, likely because most centers perform one or the other but not both. Further, the available studies [12,13], including one randomized controlled trial [14], comparing the precision of in-bore and fusion biopsies are conflicting.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

In-Bore Versus Fusion MRI–Targeted Biopsy of PI-RADS Category 4 and 5 Lesions: A Retrospective Comparative Analysis Using Propensity Score Weighting

Prince

Foster

Kaempf

et al. 2021

American Journal of Roentgenology

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“…While some studies have suggested that in-bore biopsies are superior to fusion biopsies in the detection of clinically significant PCa (14,15), it remains unknown whether the precision inherent to this spatially selective technique increases the likelihood of GG overestimation resulting in GG downgrade (eg, biopsy suggests GG4 PCa in a patient with GG2 disease due to the selective sampling of an intralesional area with greater density of Gleason pattern 4). Conversely, because systematic sampling is not performed during in-bore biopsies, MRI-invisible lesions that may be detected with fusion plus systematic biopsies could be missed with the in-bore paradigm.…”

Section: In-bore Mri-guided Biopsy Techniquementioning

confidence: 99%

“…However, despite a recent growth in the demand for in-bore biopsies, most urologists consider MRI-TRUS fusion biopsy their first choice, with in-bore biopsies reserved for cases that need to be performed with the patient under moderate sedation (eg, due to anxiety), patients with small lesions in large glands, lesions in challenging locations (eg, anterior fibromuscular stroma at the base in a man with a very large prostate), or men who underwent MRI-TRUS fusion biopsy with discordant results (eg, PI-RADS category 5 lesion and negative biopsy result). Some patients (n = 23 from the in-bore and n = 82 from the fusion biopsy cohort) were included in a previous publication focused on comparing the rate of cancer detection by both targeting approaches (14).…”

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confidence: 99%

Gleason Grade Group Concordance between Preoperative Targeted Biopsy and Radical Prostatectomy Histopathologic Analysis: A Comparison Between In-Bore MRI-guided and MRI–Transrectal US Fusion Prostate Biopsies

Costa

Cai

et al. 2021

Radiology: Imaging Cancer

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To determine and compare rates of grade group (GG) discrepancies between different targeted biopsy techniques (in-bore vs fusion) after propensity score weighting using whole-mount radical prostatectomy (RP) histopathologic analysis as the reference standard. Materials and Methods: This retrospective study evaluated men who underwent targeted (fusion or in-bore) biopsy between April 2017 and January 2019 followed by prostatectomy. The primary endpoint of the study was a change in GG from biopsy to RP at a patient level. For downgrade and upgrade analysis, men with biopsy GG1 (downgrade not possible) and GG5 (upgrade not possible) were excluded, respectively. GG upgrade, downgrade, and concordance rates of each targeting approach were compared using propensity score weighting and logistic regression with inverse probability of treatment weighting. Significance level was set at .05. Index lesion GG on RP specimen served as the reference standard. Results: A total of 191 men (90 in the in-bore [mean age, 63 years 6 7 (standard deviation)] and 101 in the fusion biopsy group [mean age, 65 years 6 7]) were eligible and included. Fewer GG upgrades were noted in the in-bore biopsy group (14%; 12 of 85) compared with the fusion plus systematic biopsy group (30%; 28 of 93) (P = .012). The incidence of GG downgrade in the in-bore group (25%; 21 of 84) was higher than in the fusion group (17%; 16 of 93); however, the difference was not statistically significant (P = .2). Of the 77 men misclassified by both biopsy techniques, the majority (56%, n = 43) had a change in GG of 2 to 3 or 3 to 2. Conclusion: Superior sampling accuracy with MRI-guided in-bore biopsies offers a lower incidence of GG upgrades compared with MRI-transrectal US fusion biopsies upon RP.

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Magnetic Resonance Imaging–guided In-bore and Magnetic Resonance Imaging-transrectal Ultrasound Fusion Targeted Prostate Biopsies: An Adjusted Comparison of Clinically Significant Prostate Cancer Detection Rate

Cited by 48 publications

References 18 publications

Comparative Effectiveness of Techniques in Targeted Prostate Biopsy

Comparative Effectiveness of Techniques in Targeted Prostate Biopsy

In-Bore Versus Fusion MRI–Targeted Biopsy of PI-RADS Category 4 and 5 Lesions: A Retrospective Comparative Analysis Using Propensity Score Weighting

Gleason Grade Group Concordance between Preoperative Targeted Biopsy and Radical Prostatectomy Histopathologic Analysis: A Comparison Between In-Bore MRI-guided and MRI–Transrectal US Fusion Prostate Biopsies

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