Patient Reported Outcome Measures for Transperineal Template Prostate Mapping Biopsies in the PICTURE Study

Miah, Saiful; Eldred‐Evans, David; Simmons, Lucy A. M.; Shah, Taimur T.; Kanthabalan, Abi; Arya, Manit; Winkler, Mathias; McCartan, Neil; Freeman, Alex; Punwani, Shonit; Moore, Caroline M.; Emberton, Mark; Ahmed, Hashim U.

doi:10.1016/j.juro.2018.06.033

Cited by 66 publications

(60 citation statements)

References 27 publications

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“…should evaluate findings from the literature in-line with the pathology and biopsy resources available to them and the degree of clinical suspicion of the patient in front of the harbouring csPCa but certainly a TPM-biopsy in all strategy will be prohibitively expensive as well as confer significant side-effects to the patients 18 . Men should be counselled accordingly prior to TRUS-biopsy and made aware of the relative advantages and disadvantages of pre-biopsy mpMRI, TRUS-biopsy and TPMbiopsies 1,2 .…”

Section: A C C E P T E D U N E D I T E D M a N U S C R I P Tmentioning

confidence: 99%

Comparison of Transrectal Ultrasound Biopsy to Transperineal Template Mapping Biopsies Stratified by Multiparametric Magnetic Resonance Imaging Score in the PROMIS Trial

et al. 2020

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In 41 months, 740 men at 11 centres were recruited; 576 underwent all three tests. Of 150 with MRI score 1-2, 8 (5.1%) had any Gleason >/=3+4 disease on TRUS-biopsy. In 75 where TRUS-biopsy showed Gleason 3+3 of any MCCL, 61/75 (81%) had Gleason 3+4, 8/75 (11%) Gleason 4+3 and 0/75 (0%) Gleason >/=4+5. For definition1 csPCa, TRUS-biopsy sensitivity remained stable and low across MP-MRI Likert scores (35%-52%). For definition2 csPCa and any cancer, sensitivity increased with higher MP-MRI score. Negative predictive value varied due to varying disease prevalence but for all cancer thresholds declined with increasing MP-MRI score. ConclusionsTRUS-biopsy in the setting of MP-MRI Likert scores 1-2 finds Gleason 3+4 disease in only 1 in 20 men. Further, for any csPCa definition, TRUS-biopsy had poor sensitivity and variable but low NPV across MP-MRI scores. Men undergoing TRUS-biopsy without targeting in the setting of MP-MRI score 3 to 5 should be advised to undergo a repeat (targeted) biopsy.

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Section: A C C E P T E D U N E D I T E D M a N U S C R I P Tmentioning

confidence: 99%

Comparison of Transrectal Ultrasound Biopsy to Transperineal Template Mapping Biopsies Stratified by Multiparametric Magnetic Resonance Imaging Score in the PROMIS Trial

et al. 2020

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“…These side effects of an intensive mapping biopsy were also seen in the PICTURE study [6]. It assessed men who had had a previous TRUS biopsy, and used a combination of a 5mm transperineal mapping biopsy, and biopsies targeted to MRI lesions.…”

Section: How Does An Mri-led Pathway Compare To a Standard Biopsy Patmentioning

confidence: 89%

MRI in early detection of prostate cancer

Giganti

Moore

2019

Current Opinion in Urology

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Purpose of review: The use of magnetic resonance imaging (MRI) in the early detection of prostate cancer (PCa) is increasing rapidly. In the last couple of years, there have been a number of key publications which have led to its adoption in the UK and European guidelines. Recent findings: PROMIS showed that standard biopsy missed up to half of clinically significant disease, compared to 5mm template mapping biopsy. Three studies then compared the standard transrectal ultrasound (TRUS) pathway to an MRI+/-targeted biopsy pathway. These showed that MRI-targeted biopsies detect more clinically significant disease and reduce overdetection of indolent disease whilst allowing between one third to one half of men to avoid an immediate biopsy. Cost effectiveness data show that using MRI to determine who gets a biopsy and how that biopsy is done is a cost-neutral approach when men at lowest risk do not undergo biopsy. Summary: Prostate MRI is a useful and cost-effective tool for early detection of PCa which minimises the impact of overdetection and overtreatment whilst maximising the detection of PCa which could benefit from treatment. The next challenge is to ensure that centres offering MRI are able to offer high quality MRI acquisition and reporting.

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“…10,11 For transperineal template mapping biopsy, adverse events have included 24% of men suffering acute urinary retention, and 41% with perineal pain and significant deterioration in functional domains. 12 This demonstrates the need for the updated NICE guideline to reduce the invasiveness of the diagnostic pathway for prostate cancer and reduce avoidable complications, with subsequent benefits also reducing the economic burden from biopsy procedures and histological analysis.…”

Section: What Is Mpmri?mentioning

confidence: 99%

“…It remains evident that while mpMRI affords numerous benefits in increasing the efficiency of diagnosing csPCa, it is not a 'golden bullet' and the time is ripe for research to further imaging technology. 11,12 The logistical implications of mpMRI triage are widespread and noteworthy. Differences afforded to diagnostics by high-standard performance and reporting of mpMRI are evidenced by heterogeneity in the literature; for instance, comparing findings from PRECISION, which utilised both 1.5T and 3.0T machines, with the work by Van der Leest et al 7,9 The updated NICE guidance has 'left this decision with the imaging centres', though advised minimum appropriate standards of 'at least 1.5T, diffusion weighted, contrastenhanced imaging and b value of at least 800'.…”

Section: What Is Mpmri?mentioning

confidence: 99%