Prostate Cancer Detection Rate with Koelis Fusion Biopsies versus Cognitive Biopsies: A Comparative Study

Oderda, Marco; Faletti, Riccardo; Battisti, Giuliana; Dalmasso, Ettore; Falcone, Marco; Marra, Giancarlo; Palazzetti, Anna; Zitella, Andrea; Bergamasco, Laura; Gandini, Giovanni; Gontero, Paolo

doi:10.1159/000445524

Cited by 27 publications

(25 citation statements)

References 23 publications

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“…However, several other factors must also be taken into account, such as the reliability of mpMRI, the skill of the operator and the presence of cancers still invisible to mpMRI. 7,16,17,20 The CDR decreases to 42% when focusing only on clinically significant PCa. To overcome these limitations, our multicenter study has gathered data from different European institutions, with the aim to provide data on the accuracy of Koelis coming from daily practice.…”

Section: Discussionmentioning

confidence: 99%

“…6,7,[16][17][18][19][20][21][22] When deciding to use a device for fusion biopsy, its precision, safety and ease of use are essential parameters to be considered. Among the devices used for this goal, Koelis is supported by quite robust evidence, showing a CDR ranging from 48% to 80%.…”

Section: Discussionmentioning

confidence: 99%

“…1 The advent of mpMRItargeted biopsies has improved the CDR, usually estimated to be approximately 33%, and in particular the detection of clinically significant cancers. 7 However, to date, several challenges exist regarding the implementation of TRUS-mpMRI fusion biopsies in clinical practice: among these, the inaccurate reading of mpMRI, which should be restricted to dedicated radiologists; 5 the presence of approximately 10% of significant cancers invisible to mpMRI; 8 the inaccurate sampling of lesions during fusion biopsy, as a result of inaccurate segmentation of mpMRI images or registration; 9 and last, but not least, mechanical error of the device used. In contrast, TRUS-mpMRI fusion biopsies achieve good results with acceptable costs, good reproducibility and accessibility for the patient.…”

Section: Introductionmentioning

confidence: 99%

“…Fusion biopsies have been shown to be superior to cognitive biopsies, and they are now routinely carried out when a lesion is detected at mpMRI. 7 However, to date, several challenges exist regarding the implementation of TRUS-mpMRI fusion biopsies in clinical practice: among these, the inaccurate reading of mpMRI, which should be restricted to dedicated radiologists; 5 the presence of approximately 10% of significant cancers invisible to mpMRI; 8 the inaccurate sampling of lesions during fusion biopsy, as a result of inaccurate segmentation of mpMRI images or registration; 9 and last, but not least, mechanical error of the device used. Keeping in mind these limitations, TRUS-mpMRI fusion biopsies are highly utilized for targeted biopsy of the prostate, using different devices.…”

Section: Introductionmentioning

confidence: 99%

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Accuracy of elastic fusion biopsy in daily practice: Results of a multicenter study of 2115 patients

et al. 2018

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Objectives To assess the accuracy of Koelis fusion biopsy for the detection of prostate cancer and clinically significant prostate cancer in the everyday practice. Methods We retrospectively enrolled 2115 patients from 15 institutions in four European countries undergoing transrectal Koelis fusion biopsy from 2010 to 2017. A variable number of target (usually 2–4) and random cores (usually 10–14) were carried out, depending on the clinical case and institution habits. The overall and clinically significant prostate cancer detection rates were assessed, evaluating the diagnostic role of additional random biopsies. The cancer detection rate was correlated to multiparametric magnetic resonance imaging features and clinical variables. Results The mean number of targeted and random cores taken were 3.9 (standard deviation 2.1) and 10.5 (standard deviation 5.0), respectively. The cancer detection rate of Koelis biopsies was 58% for all cancers and 43% for clinically significant prostate cancer. The performance of additional, random cores improved the cancer detection rate of 13% for all cancers (P < 0.001) and 9% for clinically significant prostate cancer (P < 0.001). Prostate cancer was detected in 31%, 66% and 89% of patients with lesions scored as Prostate Imaging Reporting and Data System 3, 4 and 5, respectively. Clinical stage and Prostate Imaging Reporting and Data System score were predictors of prostate cancer detection in multivariate analyses. Prostate‐specific antigen was associated with prostate cancer detection only for clinically significant prostate cancer. Conclusions Koelis fusion biopsy offers a good cancer detection rate, which is increased in patients with a high Prostate Imaging Reporting and Data System score and clinical stage. The performance of additional, random cores seems unavoidable for correct sampling. In our experience, the Prostate Imaging Reporting and Data System score and clinical stage are predictors of prostate cancer and clinically significant prostate cancer detection; prostate‐specific antigen is associated only with clinically significant prostate cancer detection, and a higher number of biopsy cores are not associated with a higher cancer detection rate.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Accuracy of elastic fusion biopsy in daily practice: Results of a multicenter study of 2115 patients

et al. 2018

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“…Oderda et al (50) retrospectively evaluated 50 men (16 with a previous negative biopsy and 5 with a previous negative transurethral resection of the prostate) undergoing fusion (n=25) or visually registered (n=25) MRI-targeted biopsy. The cancer detection rate of mpMRI targets was significantly higher in fusion (59%) than visually registered biopsies (27%) (P=0.03).…”

Section: Studies Comparing Multiple Mri-targeted Biopsy Techniquesmentioning

confidence: 99%

A critical comparison of techniques for MRI-targeted biopsy of the prostate

Giganti¹,

Moore²

2017

Transl. Androl. Urol.

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MRI-targeted biopsy is a promising technique that offers an improved detection of clinically significant prostate cancer over standard non-targeted biopsy. It is established that prostate MRI is of use in both the primary and repeat biopsy setting for the detection of significant prostate cancer. There are three approaches to targeting biopsies to areas of interest seen on prostate MRI. They each rely on the acquisition and reporting of a diagnostic quality multi-parametric MRI scan used to identify areas of interest, and the subsequent use of those diagnostic quality images in combination with real-time images of the prostate during the biopsy procedure. The three techniques are: visual registration of the MRI images with a real-time ultrasound image; software-assisted fusion of the MRI images and the real-time ultrasound images, and in-bore biopsy, which requires registration of a diagnostic quality MRI scan with a real time interventional MRI image. In this paper we compare the three techniques and evaluate those studies where there is a direct comparison of more than one MRI-targeting technique. PubMed was searched from inception to November 2016 using the search terms (cognitive registration OR visual registration OR fusion biopsy OR in-bore biopsy OR targeted biopsy) AND (prostate cancer OR prostate adenocarcinoma OR prostate carcinoma OR prostatic carcinoma OR prostatic adenocarcinoma) AND (MRI OR NMR OR magnetic resonance imaging OR mpMRI OR multiparametric MRI). The initial search included 731 abstracts. Eleven full text papers directly compared two or more techniques of MRI-targeting, and were selected for inclusion. The detection of clinically significant prostate cancer varied from 0% to 93.3% for visual registration, 23.2% to 100% for software-assisted registration and 29% to 80% for in-bore biopsy. Detection rates for clinically significant cancer are dependent on the prevalence of cancer within the population biopsied, which in turn is determined by the selection criteria [biopsy naïve, previous negative biopsy, prostate specific antigen (PSA) selection criteria, presence of a lesion on MRI]. Cancer detection rates varied more between study populations than between biopsy approaches. Currently there is no consensus on which type of MRI-targeted biopsy performs better in a given setting. Although there have been studies supporting each of the three techniques, substantial differences in methodology and reporting the findings make it difficult to reliably compare their outcomes.

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The detection rate for prostate cancer in systematic and targeted prostate biopsy in biopsy‐naive patients, according to the localization of the lesion at the mpMRI: A single‐center retrospective observational study

Massanova,

Barone,

Caputo

et al. 2024

The Prostate

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ObjectiveEvaluate the detection rates of systematic, targeted and combined cores at biopsy according to tumor positions in biopsy‐naïve patients.Material and MethodsA retrospective analysis of a single‐center patient cohort (n = 501) that underwent transrectal prostate biopsy between January 2017 and December 2019 was performed. Multi‐parametric MRI was executed as a prebiopsy investigation. Biopsy protocol included, for each patient, 12 systematic cores plus 3 to 5 targeted cores per lesion identified at the mpMRI. Pearson and McNemar chi‐squared tests were used for statistical analysis to compare tumor location‐related detection rates of systematic, targeted and combined (systematic + targeted) cores at biopsy.ResultsMedian age of patients was 70 years (IQR 62–72), with a median PSA of 8.5 ng/ml (IQR 5.7–15.6). Positive biopsies were obtained in 67.7% of cases. Overall, targeted cores obtained higher detection rates compared to systematic cores (54.3% vs. 43.1%, p < 0.0001). Differences in detection rates were, however, higher for tumors located at the apex (61.1% vs. 26.3%, p < 0.05) and anteriorly (44.4% vs. 19.3%, p < 0.05). Targeted cores similarly obtained higher detection rates in the posterior zone of the prostate gland for clinically significant prostate cancer. A poor agreement was reported between targeted and systematic cores for the apex and anterior zone of the prostate with, respectively κ = 0.028 and κ = −0.018.ConclusionA combined approach of targeted and systematic biopsy delivers the highest detection rate in prostate cancer (PCa). The location of the tumor could however greatly influence overall detection rates, indicating the possibility to omit (as for the base or posterior zone of the gland) or add (as for the apex or anterior zone of the gland) further targeted cores.

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Prostate Cancer Detection Rate with Koelis Fusion Biopsies versus Cognitive Biopsies: A Comparative Study

Cited by 27 publications

References 23 publications

Accuracy of elastic fusion biopsy in daily practice: Results of a multicenter study of 2115 patients

Accuracy of elastic fusion biopsy in daily practice: Results of a multicenter study of 2115 patients

A critical comparison of techniques for MRI-targeted biopsy of the prostate

The detection rate for prostate cancer in systematic and targeted prostate biopsy in biopsy‐naive patients, according to the localization of the lesion at the mpMRI: A single‐center retrospective observational study

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