A prospective analysis of robotic targeted MRI-US fusion prostate biopsy using the centroid targeting approach

Abstract

Robotic prostate biopsy is an emerging technology. Recent development of this tool has allowed the performance of a transperineal prostate biopsy allowing pre-programmed standardized biopsy schemes. Prospective data collection was undertaken in 86 consecutive men who underwent robotically assisted transperineal prostate biopsy. All underwent a multi-parametric MRI pre-biopsy with centroid targeting followed by systematic template prostate biopsy. For the purposes of this study, our definition of clinically significant prostate cancer (csPCa) is any Gleason score > 6. Mean (SD) age, median (IQR) PSA, and median (IQR) prostate volume were 64.24 (6.97) years, of 7.79 ng/ml (6.5) and 45.06 cc (28), respectively. Overall, 44 (51.2%) men were diagnosed with csPCa. csPCa was detected in the targeted biopsies alone in 35 (40.1%) men. The addition of the 12-zone template biopsy increased the yield of csPCa for another 9 (10.5%) men. Of these 9 men, the majority (7) harbored primary pattern 3 disease and only 1 was identified to have high-grade disease. Out of these 9 men, 7 of them had the identification of csPCa in the sector, where a target was contained within that zone. Robotic-assisted prostate biopsy in our study has demonstrated a high detection of csPCa when combined with limited near-field sampling. Our study suggests the use of more accurate biopsy schemes such as ring-targeting of lesions to mitigate against systematic and random mathematical errors. Adoption of this tool and biopsy strategy would potentially avoid the increased morbidity associated with whole gland systematic unguided biopsies.

Robotic-assisted magnetic resonance imaging ultrasound fusion results in higher significant cancer detection compared to cognitive prostate targeting in biopsy naive men

“…The majority of these positive biopsies were in the sector of the ROI, suggesting that systematic biopsies can compensate for the lower accuracy obtained from C-TB. A recent study by Miah et al examined the CDR in 86 men biopsied using the same robotic biopsy platform (15). In total, 51% were diagnosed with clinically significant cancer-slightly higher than 40% in our series.…”

Role of Prophylactic Antibiotics in Transperineal Prostate Biopsy: A Systematic Review and Meta-analysis

“…We found 39 retrospective studies, 46 prospective studies, and 13 RCTs where periprocedural antibiotics were administered [12] , [13] , [14] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] , [59] , [60] , [61] , [62] , [63] , [64] , [65] , [67] , [68] , [70] , [71] , [72] , [73] , [74] , [75] , [76] , [77] , [78] , [79] , [80] , [81] , [82] , [83] , [84] , [85] , …”

Diagnostic accuracy and clinical implications of robotic assisted MRI-US fusion guided target saturation biopsy of the prostate

“…Saturation biopsy concepts aim to detect and map any carcinoma, but harbour the risk of over-detecting clinically insignificant PCa 5 and of complications 6 . MRI-targeted approaches were shown to reduce over-detection and improve detection of clinically significant cancer 7 , and thus currently represent state of the art, even though systemic biopsy should not be omitted 8 , 9 . However, up to 70% of PCa lesions display intralesional tumor heterogeneity 10 , and targeted biopsy strategies do not yet adequately account for this finding, as the number of targeted biopsy cores varies significantly 11 – 14 and no standard has been defined.…”