Transperineal Template-guided Mapping Biopsy as a Staging Procedure to Select Patients Best Suited for Active Surveillance

Taira, Al V.; Merrick, Gregory S.; Bennett, Abbey; Andreini, Hugo; Taubenslag, Walter; Galbreath, Robert W.; Butler, Wayne M.; Bittner, Nathan; Adamovich, Edward

doi:10.1097/coc.0b013e31823fe639

Cited by 44 publications

(28 citation statements)

References 16 publications

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“…The confirmatory biopsy is an essential tool as reports have shown that more than a third of patients treated with AS for PCa are upgraded at the time of repeat biopsy or radical prostatectomy. 7,11,12 In our study TP-24 biopsy resulted in estimated upgrading prevalence similar to that of TP-V biopsy, although formal equivalence testing in a much larger cohort would be necessary to formally rule out a meaningful difference.…”

Section: Discussionsupporting

confidence: 63%

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Transperineal Template Guided Prostate Biopsy Selects Candidates for Active Surveillance—How Many Cores are Enough?

et al. 2015

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Section: Discussionsupporting

confidence: 63%

“…7e9 By systematically sampling the entire prostate TP BX provides a more accurate representation of the true extent of disease compared to a standard 12-core transrectal ultrasound biopsy in men considering AS. 7 However, to our knowledge the optimal TP BX technique has not been elucidated.…”

mentioning

confidence: 98%

Transperineal Template Guided Prostate Biopsy Selects Candidates for Active Surveillance—How Many Cores are Enough?

et al. 2015

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“…This is a percutaneous approach, in which the biopsy needle pierces through the perineum parallel to the urethra, allowing for improved sampling of the anterior and apical prostate regions while decreasing the risk of sepsis and urethral damage [19–21]. Transperineal biopsy results have also been shown to improve cancer detection rates, reduce the risk of underestimating tumor grade, and decrease the false-negative results compared to TRUS-guided biopsies [22, 23]. Targeted in-bore biopsies allow for clear needle visualization during biopsy and most importantly, confirm with imaging the correct location of the needle in the suspicious lesion, thus improving accuracy and reducing the number of core biopsies needed [11, 24].…”

Section: Introductionmentioning

confidence: 99%

Pathologic correlation of transperineal in-bore 3-Tesla magnetic resonance imaging-guided prostate biopsy samples with radical prostatectomy specimen

et al. 2017

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Purpose To determine the accuracy of in-bore transperineal 3-Tesla (T) magnetic resonance (MR) imaging-guided prostate biopsies for predicting final Gleason grades in patients who subsequently underwent radical prostatectomy (RP). Methods A retrospective review of men who underwent transperineal MR imaging-guided prostate biopsy (tpMRGB) with subsequent radical prostatectomy within 1 year was conducted from 2010–2015. All patients underwent a baseline 3-T multiparametric MRI (mpMRI) with endorectal coil and were selected for biopsy based on MR findings of a suspicious prostate lesion and high degree of clinical suspicion for cancer. Spearman correlation was performed to assess concordance between tpMRGB and final RP pathology among patients with and without previous transrectal ultrasound (TRUS)-guided biopsies. Results A total of 24 men met all eligibility requirements, with a median age of 65 years (interquartile range [IQR] 11.7). The median time from biopsy to RP was 85 days (IQR 50.5). Final pathology revealed Gleason 3+4=7 in 12 patients, 4+3=7 in 10 patients, and 4+4=8 in 2 patients. A strong correlation (ρ: +0.75, p<0.001) between tpMRGB and RP results was observed, with Gleason scores concordant in 17 cases (71%). 16 of the 24 patients underwent prior TRUS biopsies. Subsequent tpMRGB revealed Gleason upgrading in 88% of cases, which was concordant with RP Gleason scores in 69% of cases (ρ: +0.75, p<0.001). Conclusion Final Gleason scores diagnosed by tpMRGB at 3-T correlate strongly with final RP surgical pathology. This may facilitate prostate cancer diagnosis, particularly in patients with negative or low-grade TRUS biopsy results in whom clinically significant cancer is suspected or detected on mpMRI.

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“…Using such a volume-adjusted stringent systematic saturation approach, the combination of the two biopsy methods did not have significant additional benefit. The detected overall cancer rates with 65% for all patients and 72, 45, and 81% for the primary biopsy cohort, the repeat biopsy cohort, and the surveillance cohort, respectively, are clearly compatible compared to other transperineal template-guided saturation (TTSB) or mapping biopsy studies (TTPM): for primary biopsy cohorts, detection rates of 54-76% have been reported using a mean amount of 19-54 cores [20][21][22][23] ; and for repeat biopsy cohorts, detection rates of 26-68% with a mean amount of 18-59 cores have been reported [21,22,[24][25][26][27][28][29] . In series in which TTPM biopsies was followed by RP, TTPM was highly accurate in detecting and excluding clinically significant disease [30,31] .…”

Section: Discussionmentioning

confidence: 74%

TOP: Prospective Evaluation of a Volume Based, Computer Assisted Method for Transperineal Optimized Prostate Biopsy

et al. 2017

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Objective: This study is a prospective evaluation of a volume-based, computer-assisted method for transperineal optimized prostate (TOP) biopsy. The TOP algorithm automates core planning for systematic prostate biopsies using the 3-dimensional organ contour and an alterable volume for tumors to be excluded. Subjects and Methods: MRI-transrectal ultrasound fusion biopsy with MRI-targeted biopsies (TBs) and systematic-TOP biopsies were performed on 172 men between October 2013 and March 2014. Systematic biopsies were placed according to TOP for detection of tumor volumes >0.5 mL with a minimum of 80% organ coverage in prostates up to 50 mL (70% in larger organs). Results: Median 24 TOP cores and 3 MRI-TBs have been placed. Prostate cancer (PCa) was detected in 112 of 172 (65%) of men; TOP detected 109 (97%) and TB 62 (55%). Significant cancer (Gleason score ≥7) was detected in 75 (44%) of men and of these TOP detected 73 of 75 (97%) and TB 51 of 75 (68%). Overall, systematic-TOP sampling significantly outperformed TB for the detection of both, all PCa as well as significant PCa (p < 0.0001, p = 0.0005). Conclusion: The TOP method is innovative by integrating the individual prostate volume and PCa volume detection thresholds. In the present cohort, it diagnosed more significant tumors than TB alone. However, at the same time, more low-risk tumors are detected.

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Transperineal Template-guided Mapping Biopsy as a Staging Procedure to Select Patients Best Suited for Active Surveillance

Abstract: TRUS biopsy underestimates disease extent and Gleason score in some patients. TTMB provides a more accurate assessment of the presence of aggressive histology.

Cited by 44 publications

References 16 publications

Transperineal Template Guided Prostate Biopsy Selects Candidates for Active Surveillance—How Many Cores are Enough?

Transperineal Template Guided Prostate Biopsy Selects Candidates for Active Surveillance—How Many Cores are Enough?

Pathologic correlation of transperineal in-bore 3-Tesla magnetic resonance imaging-guided prostate biopsy samples with radical prostatectomy specimen

TOP: Prospective Evaluation of a Volume Based, Computer Assisted Method for Transperineal Optimized Prostate Biopsy

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