The effectiveness of mapping-targeted biopsies on the index lesion in transperineal prostate biopsies

Abstract

Purpose: To evaluate the eff ectiveness of mapping-targeted biopsies (MTB) on the index lesion for the detection of clinically significant prostate cancer (csPCa) in transperineal fusion-image prostate biopsies. Materials and Methods:A retrospective analysis was conducted on 309 men with suspected PCa who underwent prostate biopsies at the Creu Blanca reference center in Barcelona, Spain. The Prostate Imaging-Reporting and Data System (PI-RADS v.2.1) of the magnetic resonance images (MRI) were reclassified by an expert radiologist reading of pre-biopsy biparametric MRI used for segmentation of suspected lesions. Transperineal MTB of suspicious lesions and 12-core systematic biopsies were performed using the Artemis™ platform.CsPCa was defined as International Society of Urological Pathology grade group ≥ 2.Results: CsPCa was detected in 192 men (62.1%), with detection rates of 6.3% for PI-RADS 2, 26.8% for PI-RADS 3, 87.3% for PI-RADS 4, and 93.1% for PI-RADS 5. MTB of the index lesion identified 185 csPCa (96.3%). CsPCa was detected solely in systematic biopsies in three cases (1.6%), while an additional four cases (2.1%) were identified only in the second suspected lesion. A predictive model for csPCa detection in MTB of the index lesion was developed, with an AUC of 0.918 (95% CI 0.887-0.950). Conclusions:This model had the potential to avoid 23.3% of prostate biopsies without missing additional csPCa cases. MTB of the index lesion was highly eff ective for identifying csPCa in fusion transperineal prostate biopsies. A developed predictive model successfully reduced the need for almost one quarter of biopsies without missing csPCa cases.

MRI and biopsy in prostate cancer are the hot topic in this number of International Brazilian Journal of Urology

“…Dr. Paesano and collegues from Spain, performed in page 296 ( 4 ) a nice study about the effectiveness of mapping-targeted biopsies on the index lesion in transperineal prostate biopsies and concluded that this model had the potential to avoid 23.3% of prostate biopsies without missing additional csPCa cases. Mapping-targeted biopsies of the index lesion was highly effective for identifying clinically significant prostate cancer (csPCa) in fusion transperineal prostate biopsies.…”