Targeted vs systematic robot‐assisted transperineal magnetic resonance imaging‐transrectal ultrasonography fusion prostate biopsy

Mischinger, Johannes; Kaufmann, Sascha; Russo, Giorgio Ivan; Harland, Niklas; Rausch, Steffen; Amend, Bastian; Scharpf, Marcus; Loewe, Lorenz; Todenhoefer, Tilman; Notohamiprodjo, Mike; Nikolaou, Konstantin; Stenzl, Arnulf; Bedke, Jens; Kruck, Stephan

doi:10.1111/bju.14089

Cited by 29 publications

(34 citation statements)

References 27 publications

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“…In the present study, as well as in other reports on Chinese patients [14, 21], there tends to be more PCa patients at high risk and in an advanced stage compared to data from western countries [15–18]. In Yang T’s biopsy cohort [21], they had 34.6% patients with a PSA level ≥ 20 ng/ml, 33.6% PCa patients with a Gleason score ≥ 8, and a total PC detection rate of 45.6%, similar to the results found in our study (32.5, 37.5, and 48.4%, respectively).…”

Section: Discussionsupporting

confidence: 75%

“…Targeted biopsies of the prostate under the guidance of TRUS have been widely reported with different modalities in different populations. Mischinger J and colleagues [18] reported a total and csPC detection rate of 61 and 51.9%, respectively, by using robot-assistant transperineal TB plus an SB technique in 202 patients with suspicious mpMRI. Hakozaki Y and colleagues [19] evaluated the effectiveness of MRI/US fusion TB on csPC detection and the positive rate was 57.1, 48.0, and 63.3% for SB, TB and the combination, respectively.…”

Section: Discussionmentioning

confidence: 99%

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Surface-projection-based transperineal cognitive fusion targeted biopsy of the prostate: an original technique with a good cancer detection rate

Wang

Zhao

et al. 2019

BMC Urol

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BackgroundTo report a new standardized cognitive fusion technique on transperineal targeted biopsy (TB) of prostate, and to evaluate its efficacy for cancer detection combined with systematic biopsy (SB) .MethodsWe present a retrospective review of consecutive patients undergoing multiparametric magnetic resonance (mpMRI) imaging of the prostate with subsequent transperineal prostate biopsy from January 2016 to December 2018. A free-hand 12-core SB was performed for each patient. PI-RADS 3–5 lesions were further targeted for biopsy with our TB technique. Firstly, a central point of suspicious lesion (B′) was registered cognitively on a transverse section of transrectal ultrasound (TRUS). Then, biopsy gun punctured vertically through a fixed pioneer site (A) on skin of perineum, and deep into the TRUS section to get A’. Next, targeted site (B), the surface-projection of B′, would be determined on skin of perineum by A and distance from B′ to A’. Finally, puncture through B to reach B′. Pathological findings of SB and TB were analyzed.ResultsA total of 126 patients underwent transperineal prostate biopsy (47 SB only, 79 SB + TB). The age of the patients was 68.7 ± 9.2 years. The median preoperative PSA value was 11.8 ng/mL. Preoperative prostate volume was 60.5 ± 50.0 mL. The numbers of patients with PI-RADS scores of 1 through 5 were 4, 43, 27, 21 and 31, respectively. The overall detection rate of cancer was 61/126 (48.4%), and it was significantly higher in the combination cohort (56/79, 70.9%) compared with the SB only cohort (5/47, 10.6%, p<0.001). When focused on the combination cohort, TB detected a similar overall rate of PCa (53/79, 67.1% vs 52/79, 65.8%; p = 0.87) compared with SB. The clinically significant PCa (csPC) detection rate was 52/79 (65.8%), while for TB and SB the csPC/PC rate was 51/53 (96.2%) and 48/52 (92.3%), respectively(p = 0.44). TB demonstrated a better sampling performance (positive rate for each core) compared with SB (51.0% vs 31.3%, p < 0.001).ConclusionsSurface-projection-based transperineal cognitive fusion targeted biopsy of the prostate has a good efficacy in detecting PCa.

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Section: Discussionsupporting

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Surface-projection-based transperineal cognitive fusion targeted biopsy of the prostate: an original technique with a good cancer detection rate

Wang

Zhao

et al. 2019

BMC Urol

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“… using a four‐core transrectal TB approach (73% sensitivity for Gleason score ≥7) and Mischinger et al. for a four‐core robot‐assisted transperineal keyhole biopsy (80% sensitivity for Gleason score ≥7). Calio et al.…”

Section: Discussionmentioning

confidence: 99%

Optimising the number of cores for magnetic resonance imaging‐guided targeted and systematic transperineal prostate biopsy

et al. 2019

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ObjectivesTo assess cancer detection rates of different target-dependent transperineal magnetic resonance (MR)/ultrasonography (US) fusion-guided biopsy templates with reduced number of systematic cores. Patients and MethodsSingle-centre outcome of transperineal MR/US fusionguided biopsies of 487 men with a single target MR imaging (MRI) lesion, prospectively collected between 2012 and 2016. All men underwent transperineal targeted biopsy (TB) with two cores, followed by 18-24 systematic sector biopsies (SB) using the Ginsburg protocol. Gleason score ≥7 prostate cancer detection rates for two-core TB, fourcore extended TB (eTB), 10-to 20-core saturation TB (sTB) including cores from sectors adjacent to the target, and 14 core ipsilateral TB (iTB) were compared to combined TB+SB. ResultsCancer was detected in 345 men and Gleason score 7-10 cancer in 211 men. TB alone detected 67%, eTB 76%, sTB 91% and iTB 91% of these Gleason score 7-10 cancers. In the subgroup of 33 men (7% of cohort) with an anterior >0.5 mL highly suspicious MRI lesion and a prostate volume ≤45 mL, four-core eTB detected 31 of 32 cancers (97%) and all 26 Gleason score 7-10 cancers.Conclusion sTB detected Gleason score 7-10 cancer in 25% more of the men than a two-core TB approach, and in almost as many men (91%) as the 20-26-core combined TB+SB, while needing only 10-20 cores. A four-core extended TB may suffice for large, highly suspicious anterior lesions in small or slightly enlarged prostates.

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“…After an initial negative biopsy and in the persistent clinical suspicion of PCa, contemporary guidelines recommend performing mpMRI before repeat biopsy [1]. mpMRI-targeted biopsies may detect clinically significant PCa in up to 54% of patients, having a higher detection rate than standard systematic biopsies [2][3][4][5][6]. In this group of men, systematic plus imaging-targeted biopsies for PI-RADS 4-5 lesions (at least two cores from each MRI-defined target) were recommended, while it was recommended that biopsy could be avoided for PI-RADS 1-2 lesions [2].…”

Section: Biopsymentioning

confidence: 99%

“…Advances in imaging have led to the development of fusion biopsy platforms in which mpMRI images are electronically superimposed in real time on transrectal ultrasound (TRUS) images. Numerous targeted biopsy platforms exist and can perform biopsies of suspicious regions seen on the prostate mpMRI [2][3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Prostate Indeterminate Lesions on Magnetic Resonance Imaging—Biopsy Versus Surveillance: A Literature Review

Rivas

Giganti

Maestro

et al. 2019

European Urology Focus

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In some patients who have an MRI scan of their prostate, the scan may identify an area which may or may not contain cancer. This area is typically called the "indeterminate" lesion. In this report, we attempted to define the concept of indeterminate lesion on multiparametric magnetic resonance (mpMRI) and described the strategies that may be performed for these patients. The use of mpMRI in conjunction with traditional clinical parameters may allow more accurate risk stratification and assessment of the need for prostate biopsy.

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Targeted vs systematic robot‐assisted transperineal magnetic resonance imaging‐transrectal ultrasonography fusion prostate biopsy

Cited by 29 publications

References 27 publications

Surface-projection-based transperineal cognitive fusion targeted biopsy of the prostate: an original technique with a good cancer detection rate

Surface-projection-based transperineal cognitive fusion targeted biopsy of the prostate: an original technique with a good cancer detection rate

Optimising the number of cores for magnetic resonance imaging‐guided targeted and systematic transperineal prostate biopsy

Prostate Indeterminate Lesions on Magnetic Resonance Imaging—Biopsy Versus Surveillance: A Literature Review

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