Multiparametric magnetic resonance imaging-transrectal ultrasoundguided cognitive fusion biopsy of the prostate: Clinically significant cancer detection rates stratified by the Prostate Imaging and Data Reporting System version 2 assessment categories

John, Susan; Cooper, Steven H.; Breau, Rodney H.; Flood, Trevor A.; Cagiannos, Ilias; Lavallée, Luke T.; Morash, Christopher; O'Sullivan, Joseph P.; Schieda, Nicola

doi:10.5489/cuaj.5254

Cited by 11 publications

(12 citation statements)

References 26 publications

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“…Kasivisvanathan et al stated that MRI-guided biopsies diagnosed more csPCa than SB, and the ratio of csPCa missed by MRI-guided biopsy but diagnosed by additional was 13% (21). John et al performed CTB and concomitant SB in 131 men; 17.6% of the clinically significant cancers were detected with CTB only, and 8.4% were detected with SB only (22). In the current study, the csPCa detection rate was significantly higher in SB compared to CTB; 35% of the significant cancers would be missed without SB.…”

Section: Discussionmentioning

confidence: 40%

Systematic versus cognitive targeted biopsy: evaluation of parameters related to clinically significant prostate cancer and comparison of detection rates

et al. 2022

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Objective: This study aims to compare the clinically significant prostate cancer (csPCa) detection rates of cognitive targeted biopsy (CTB) and systematic biopsy (SB) and to reveal the factors affecting csPCa detection rates. Material and Methods: Patients diagnosed with localized prostate cancer between 2016-2019 were evaluated retrospectively. Patients who underwent SB and concomitant CTB were recorded. The number of cores taken from the index lesion in CTB, age, prostate-specific antigen (PSA) level, Gleason score, International Society of Urological Pathology (ISUP) grade, Prostate Imaging and Data Reporting System (PIRADS) score, the diameter of index lesion, and digital rectal examination (DRE) findings was recorded. We also studied whether there was a concordance between the localization of the lesion on MRI (magnetic resonance imaging) and the localization of the nodule detected on DRE. Results: Eighty patients were included in the study. csPCa was detected in 55 (68.7%) patients with SB, whereas CTB alone detected csPCa in 35 (43.7%) patients (p<0,01). SB missed 2 patients with csPCa, but 35% of the men with csPCa would be missed by CTB. Detection rates of csPCa in SB and CTB were significantly higher in patients with a concordance between DRE and mpMRI (p= 0.012 and p<0.01, respectively). In patients who had csPCa in CTB, significant differences were detected in the mean age, prostate volume, PSA, lesion diameter, number of cores, and PIRADS score (p=0.005, p=0.02, p=0.005, p=0.003, p=0.017, and p=0.002, respectively) Conclusion: SB maintains its importance in the diagnosis of csPCa. CTB can be preferred in patients with larger lesions. Keywords: Prostate cancer, prostate biopsy, magnetic resonance imaging, targeted biopsy

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Section: Discussionmentioning

confidence: 40%

Systematic versus cognitive targeted biopsy: evaluation of parameters related to clinically significant prostate cancer and comparison of detection rates

et al. 2022

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“…A recent study reported that the overall sPCa detection rate in TB was 32% and the sPCa detection rates for PI-RADS 3, 4, and 5 lesions were 11.0%, 42.9%, and 35.6%, respectively. 13 In a 2014 study, Sonn et al. 14 reported the overall sPCa detection rate in patients who underwent TB as 24%.…”

Section: Discussionmentioning

confidence: 99%

What is the ideal number of biopsy cores per lesion in targeted prostate biopsy?

Sönmez

Demirtaş

Tombul

et al. 2020

Prostate International

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Background The number of cores to be obtained in targeted biopsy (TB) is important. This study aimed to evaluate the TB outcomes in suspicious prostate lesions classified according to the Prostate Imaging Reporting and Data System (PI-RADS) and to determine the ideal number of biopsy cores per lesion. Methods This retrospective study included patients who underwent multiparametric magnetic resonance imaging–guided fusion prostate biopsy owing to increased serum prostate-specific antigen (PSA) levels and suspicious digital rectal examination outcomes in our institute. Patients with PI-RADS <3 lesions, PSA levels >10 ng/ml, and a prior diagnosis of prostate cancer (PCa) (active surveillance) were excluded from the study. The number of biopsy cores to be obtained from each lesion was determined by the clinician. Results The study included a total of 418 patients and 684 lesions. Among PI-RADS 3 lesions, clinically significant PCa (sPCa) detection rate was similar in the lesions from which 2 and 3 cores were obtained (9.1% and 10.0%, respectively), whereas it was relatively higher in the lesions from which 4 biopsy cores were obtained (18.5%). Among PI-RADS 4 lesions, sPCa detection rate was similar in the lesions from which 3 and 4 cores were obtained (35.6% and 32.3%, respectively), whereas it was relatively lower in the lesions from which 2 biopsy cores were obtained (17.9%). Among PI-RADS 5 lesions, however, sPCa detection rate was similar in the lesions from which 2, 3, or 4 cores were obtained (47.6%, 46.0%, 48.9%, respectively). Conclusion The results indicated that the ideal number of cores to be obtained from each suspicious lesion in TB depends on the characteristics of the lesions. Accordingly, while obtaining 2–3 biopsy cores could be adequate in PI-RADS 4 and 5 lesions, which have a serious risk of cancer, a minimum of 4 biopsy cores should be obtained from PI-RADS 3 lesions to ensure accurate histopathological results. Clinical trial number ( ClinicalTrials.gov ) NCT03936296 .

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“…On the other hand, an alternative clinical approach is to begin with mpMRI to determine which patients need a targeted biopsy (21,22). The detection rate of csPCa is directly related to the PI-RADS score (Table II) (11,(23)(24)(25)(26)(27)(28)(29)(30) and the results depend on clinical parameters, the number of previous negative biopsies and the quality of TPBx procedures; in a previous series, we reported a percentage of missed csPCa equal to 8.7 versus 23.5 versus 16.2 versus 0% in the presence of a PI-RAS score <3 versus 3 versus 4 versus 5 in patients that were diagnosed by transperineal SPBx (11). In addition, it is still unclear when and which mpMRI lesions negative for cancer should be submitted early to repeat TPBx; in this respect, about 15-20% of PI-RADS 3 could harbour a csPCa resulting in reclassification to PIRADS score 4 in a year (24,25).…”

Section: Discussionmentioning

confidence: 99%

“…In addition, it is still unclear when and which mpMRI lesions negative for cancer should be submitted early to repeat TPBx; in this respect, about 15-20% of PI-RADS 3 could harbour a csPCa resulting in reclassification to PIRADS score 4 in a year (24,25). On the other hand, the detection rate of csPCa in the presence of PI-RADS score 5 versus 4 is extremely variable ranging from 35.6-100% (11,26) to 34-62.7% (23)(24)(25)(26)(27) of the cases, respectively.…”

Section: Discussionmentioning

confidence: 99%

Early Second Round Targeted Biopsy of PI-RADS Score 3 or 4 in 256 Men With Persistent Suspicion of Prostate Cancer

Pepe

Garufi

Priolo

et al. 2019

In Vivo

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Multiparametric magnetic resonance imaging-transrectal ultrasoundguided cognitive fusion biopsy of the prostate: Clinically significant cancer detection rates stratified by the Prostate Imaging and Data Reporting System version 2 assessment categories

Cited by 11 publications

References 26 publications

Systematic versus cognitive targeted biopsy: evaluation of parameters related to clinically significant prostate cancer and comparison of detection rates

Systematic versus cognitive targeted biopsy: evaluation of parameters related to clinically significant prostate cancer and comparison of detection rates

What is the ideal number of biopsy cores per lesion in targeted prostate biopsy?

Early Second Round Targeted Biopsy of PI-RADS Score 3 or 4 in 256 Men With Persistent Suspicion of Prostate Cancer

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