Is it necessary for all patients with suspicious lesions undergo systematic biopsy in the era of MRI-TRUS fusion targeted biopsy?

Lv, Zhengtong; Wang, Jinfu; Wang, Miao; Hou, Huimin; Song, Liuqi; Li, Haodong; Wang, Xuan; Liu, Ming

doi:10.1590/s1677-5538.ibju.2023.0060

Cited by 5 publications

(3 citation statements)

References 31 publications

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“…Imaging of the prostate with mpMRI has become increasingly valuable in prostate cancer management as image quality has improved with advancements like high-field strength magnets. For initial management, mpMRI is particularly useful for improving detection of clinically significant prostate cancer and guiding both transrectal and transperineal targeted biopsies ( 11 - 13 ). Although mpMRI is not yet integrated in guidelines for preoperative planning, mpMRI findings are likely to influence the surgical plan especially in high-risk tumors ( 14 ).…”

Section: Discussionmentioning

confidence: 99%

Less qualitative multiparametric magnetic resonance imaging in prostate cancer can underestimate extraprostatic extension in higher grade tumors

Schmit,

Allu,

Tanzer

et al. 2024

Int. braz j urol.

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Background: Multiparametric magnetic resonance imaging (mpMRI) is increasingly used for risk stratification and preoperative staging of prostate cancer. It remains unclear how Grade Group (GG) interacts with the ability of mpMRI to determine the presence of extraprostatic extension (EPE) on surgical pathology. Methods: A retrospective review of a robotic assisted laparoscopic radical prostatectomy (RALP) database from 2016-2020 was performed. Radiology mpMRI reports by multiple attending radiologists and without clear standardization or quality control were retrospectively assessed for EPE findings and compared with surgical pathology reports. The data were stratified by biopsy-based GG and a multivariable cluster analysis was performed to incorporate additional preoperative variables (age at diagnosis, PSA, etc.). Hazard ratios were calculated to determine how mpMRI findings and radiographic EPE relate to positive surgical margins. Results: Two hundred and eighty nine patients underwent at least one mpMRI prior to RALP. Preoperative mpMRI demonstrated sensitivity of 39.3% and specificity of 88.8% for pathological EPE and had a negative predictive value (NPV) of 49.5%, and positive predictive value (PPV) of 84.0%. Stratification of NPV by GG yielded the following values: GG 1-5 (49.5%), GG 3-5 (40.8%), GG 4-5 (43.4%), and GG 5 (30.4%). Additionally, positive EPE on preoperative mpMRI was associated with a significantly decreased risk of positive surgical margins (RR: 0.655; 95% CI: 0.557-0.771). Conclusions: NPV of prostate mpMRI for EPE may be decreased for higher grade tumors. A detailed reference reading and image quality optimization may improve performance. However, urologists should exercise caution in nerve sparing approaches in these patients.

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Section: Discussionmentioning

confidence: 99%

Less qualitative multiparametric magnetic resonance imaging in prostate cancer can underestimate extraprostatic extension in higher grade tumors

Schmit,

Allu,

Tanzer

et al. 2024

Int. braz j urol.

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“…It is also true that the results of FT heavily rely on good quality multi-parametric MRI (mpMRI). Although significant advances have been made in the field of mpMRI, inter-reader variability is an issue, as is access to high-quality scans, especially in developing countries, this is one of the many reasons PCa diagnosis should still be done with targeting and systematic biopsies ( 6 ). However, every day wider acknowledgment of the importance of mpMRI on PCa detection is making this diagnostic tool more accessible, even in lower-income countries.…”

Section: Introductionmentioning

confidence: 99%

Focal Therapy: Overcoming Barriers for Advances in Prostate Cancer Treatment in South America

Ezequiel,

Marcelo,

Polascik

et al. 2024

Int. braz j urol.

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“…Dr. Lv and collegues from China performed in page 359 (7) the cover paper of this edition. In this paper the authors studied if is it necessary for all patients with suspicious lesions undergo systematic biopsy in the era of MRI-TRUS fusion targeted biopsy and concluded that the mean PSA density (PSAD) combined with PI-RADS showed utility in guiding optimization of the prostate biopsy mode.…”

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confidence: 99%

MRI-TRUS fusion targeted biopsy is highligheted in International Brazilian Journal of Urology

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2023

Int. braz j urol.

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The May-June number of Int Braz J Urol is the 22 nd under my supervision. In this number the Int Braz J Urol presents original contributions with a lot of interesting papers in different fields: Robotic Surgery, Prostate Cancer, Endometriosis, Translational Research, Male Health and Renal stones, Kidney Cancer, Bladder Cancer and UPJ obstruction. The papers came from many different countries such as Brazil, Italy, China, Saudi Arab and USA, and as usual the editor´s comment highlights some of them. The editor in chief would like to highlight the following works:Dr. Wang and collegues from China, presented in page 281 (1) a nice systematic review about the impact of body mass index (BMI) on size and composition of urinary stones and concluded that the current evidence suggests a positive association between BMI and uric acid and calcium oxalate stones. It would be of great guiding significance to con-sider losing weight when treating and preventing urinary stones.Dr. Ribeiro-Julio and collegues from Brazil, presented in page 299 (2) a important review about the anatomy of the lower hypogastric plexus applied to endometriosis and concluded that the Accurate knowledge of the innervation of the female pelvis is of fundamental importance for prevention of possible injuries and voiding dysfunctions as well as the evacuation mechanism in the postoperative period. Imaging exams such as nuclear magnetic resonance are interesting tools for more accurate visualization of the distribution of the hypogastric plexus in the female pelvis.Dr. da Silva and collegues from Brazil, performed in page 320 (3) a interesting translational research about the effects of dutasteride and tamsulosin on penile morphology in a rodent model and concluded that both treatments with dutasterid and tamsulosin promoted penile morphometric modifications in a rodent model. The combination therapy resulted in more notable modifications. The results of this study may help to explain the erectile dysfunction observed in some men using these drugs.Dr. Moratti Gilberto and collegues from Brazil performed in page 334 (4) an interesting study

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Is it necessary for all patients with suspicious lesions undergo systematic biopsy in the era of MRI-TRUS fusion targeted biopsy?

Cited by 5 publications

References 31 publications

Less qualitative multiparametric magnetic resonance imaging in prostate cancer can underestimate extraprostatic extension in higher grade tumors

Less qualitative multiparametric magnetic resonance imaging in prostate cancer can underestimate extraprostatic extension in higher grade tumors

Focal Therapy: Overcoming Barriers for Advances in Prostate Cancer Treatment in South America

MRI-TRUS fusion targeted biopsy is highligheted in International Brazilian Journal of Urology

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