Diagnostic Accuracy of Robot-Guided, Software Based Transperineal MRI/TRUS Fusion Biopsy of the Prostate in a High Risk Population of Previously Biopsy Negative Men

Kroenig, Malte; Schaal, Kathrin; Benndorf, Matthias; Soschynski, Martin; Lenz, Philipp; Krauß, Tobias; Drendel, Vanessa; Kayser, Gian; Kurz, Philipp; Werner, Martin; Wetterauer, Ulrich; Schultze-Seemann, Wolfgang; Langer, Mathias; Jilg, Cordula A.

doi:10.1155/2016/2384894

Cited by 23 publications

(22 citation statements)

References 23 publications

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“…Our findings provide a timely evaluation of the utilization of robotic equipment in the prostate cancer diagnostic pathway that utilizes the clinically superior transperineal route. There has been an increased adoption of this technology in units globally but with minimal reported outcomes [9][10][11]. The detection range of csPCa for all the previous similar studies is 50.0%, 52.7%, and 61% which is in-keeping with our overall detection rate of 51.2%.…”

Section: Discussionsupporting

confidence: 84%

“…Our study limitations include the heterogeneous nature of our cohort of men which included those with the previous negative prostate biopsy and men who underwent this diagnostic test for the first time. Our study has a small size; however, with the exception of study by Mischinger et al [11], our data report on a larger series than found in the literature [9,10]. All men underwent the procedure under general anesthesia.…”

Section: Discussionmentioning

confidence: 56%

“…No man had more than 3 target lesions identified in the pre-biopsy mpMRI (range 1-3) with a median (IQR) number of targeted biopsy per patient of 8 (4). The median number (IQR) of non-targeted biopsy per patient was 20 (9).…”

Section: Demographicsmentioning

confidence: 99%

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

et al. 2019

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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.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 56%

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

et al. 2019

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“…Robot-assisted mpMRI/TRUS fusion biopsy of the prostate (iSRobot Mona LisaTM ® , Biobot Surgical, Singapore, Singapore) was performed as a combined strategy by targeting suspicious lesions followed by SB in the same session. Procedural details were described in previous investigations [11]. Eight different surgeons performed the biopsy procedures that were reviewed for this study.…”

Section: Biopsy Proceduresmentioning

confidence: 99%

Evaluation of the Ginsburg Scheme: Where Is Significant Prostate Cancer Missed?

Sigle

Jilg

Kuru³

et al. 2021

Cancers

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Background: Systematic biopsy (SB) according to the Ginsburg scheme (GBS) is widely used to complement MRI-targeted biopsy (MR-TB) for optimizing the diagnosis of clinically significant prostate cancer (sPCa). Knowledge of the GBS’s blind sectors where sPCa is missed is crucial to improve biopsy strategies. Methods: We analyzed cancer detection rates in 1084 patients that underwent MR-TB and SB. Cancerous lesions that were missed or underestimated by GBS were re-localized onto a prostate map encompassing Ginsburg sectors and blind-sectors (anterior, central, basodorsal and basoventral). Logistic regression analysis (LRA) and prostatic configuration analysis were applied to identify predictors for missing sPCa with the GBS. Results: GBS missed sPCa in 39 patients (39/1084, 3.6%). In 27 cases (27/39, 69.2%), sPCa was missed within a blind sector, with 17/39 lesions localized in the anterior region (43.6%). Neither LRA nor prostatic configuration analysis identified predictors for missing sPCa with the GBS. Conclusions: This is the first study to analyze the distribution of sPCa missed by the GBS. GBS misses sPCa in few men only, with the majority localized in the anterior region. Adding blind sectors to GBS defined a new sector map of the prostate suited for reporting histopathological biopsy results.

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“…The patients received no transurethral catheter. The detailed procedure has been described previously 16,17 . We analysed the histopathologic results of all targeted biopsies (B x ) taken from lesions in which cancer was detected, and calculated the diagnostic yield on a per-lesion level and on a per-patient level.…”

Section: -D Modeling Equipment Biopsy Technique and Histological Analysismentioning

confidence: 99%

Robotic Assisted MRI-US Fusion Guided Target Saturation Biopsy of the Prostate – Diagnostic Accuracy and Clinical Implications

Wetterauer

Trotsenko

Matthias

et al. 2021

Preprint

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MRI-targeted prostate biopsy improves detection of clinically significant prostate cancer (PCa). However, up to 70% of PCa lesions display intralesional tumor heterogeneity. Current target sampling strategies do not yet adequately account for this finding. This prospective study included 118 patients who underwent transperineal robotic assisted biopsy of the prostate. We identified a total of 58 PCa-positive PI-RADS lesions. We compared diagnostic accuracy of a target-saturation biopsy strategy to accuracy of single, two, or three randomly selected targeted biopsies and analysed potential clinical implications. Intralesional detection of clinically significant cancer (ISUP ≥ 2) was 78.3% for target-saturation biopsy and 39.1%, 52.2%, and 67.4% for one, two, and three targeted cores, respectively. Target-saturation biopsies led to a more accurate characterization of PCa in terms of Gleason score and reduced rates of missed cancer. Compared to one, two, and three targeted biopsies, target-saturation biopsies led to intensified staging procedures in 21.7%, 10.9, and 8.7% of patients, and ultimately to a potential change in therapy in 39.1%, 26.1%, and 10.9% of patients. This work presents the concept of robotic-assisted target saturation biopsy. This technique has the potential to improve diagnostic accuracy and thus individual staging procedures and treatment decisions.

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Diagnostic Accuracy of Robot-Guided, Software Based Transperineal MRI/TRUS Fusion Biopsy of the Prostate in a High Risk Population of Previously Biopsy Negative Men

Cited by 23 publications

References 23 publications

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

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

Evaluation of the Ginsburg Scheme: Where Is Significant Prostate Cancer Missed?

Robotic Assisted MRI-US Fusion Guided Target Saturation Biopsy of the Prostate – Diagnostic Accuracy and Clinical Implications

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