Direct Comparison of Targeted MRI-Guided Biopsy with Systematic Transrectal Ultrasound-Guided Biopsy in Patients with Previous Negative Prostate Biopsies

Kaufmann, Sascha; Kruck, Stephan; Krämer, Ulrich; Gatidis, Sergios; Stenzl, Arnulf; Roethke, Matthias; Scharpf, Marcus; Schilling, David

doi:10.1159/000365397

Cited by 42 publications

(34 citation statements)

References 23 publications

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“…MRI is the most accurate imaging modality for the localization of PCa, the only clinical imaging method that depicts the zonal anatomy of the prostate in detail [24]. When PB is targeted to MRI-detected lesion, the diagnosis of PCa and the percentage of significant PCa focus increase [25,26]. van den Bos et al [3] recommends the inclusion of MRI before considering the FT, due to the high negative predictive value (up to 95%) for clinically significant tumours [27].…”

Section: Discussionmentioning

confidence: 99%

Twelve Core Template Prostate Biopsy is an Unreliable Tool to Select Patients Eligible for Focal Therapy

Fumadó¹,

Rosell²,

Juanpere³

et al. 2015

Urol Int

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Introduction: To determine whether unilateral prostate cancer diagnosed at 12-core prostate biopsy harbours relevant prostate cancer foci in contralateral lobe in cases eligible for hemiablative focal therapy. Material and Methods: We analysed 112 radical prostatectomies of unilateral Gleason 6/7 prostate cancer based on prostate biopsy information. The presence of significant prostate cancer foci and/or the index lesion in the contralateral lobe is described. A subanalysis is performed in cases of Gleason score 6 and in cases of very-low-risk prostate cancer. Results: Contralateral prostate cancer was present in 69.6% of cases, fulfilling significant prostate cancer criteria in 33% and being the index lesion in 32%. No significant differences were found when analysing the Gleason 6 group (73% contralateral prostate cancer, 34% significant prostate cancer and 35% index lesion) or the very-low-risk prostate cancer group (80% contralateral prostate cancer, 29% significant prostate cancer and 45% index lesion). Conclusions: The assumption of unilateral prostate cancer based on 12-core template prostate biopsy information is unreliable. In about one third of the cases, there will be focus of significant prostate cancer or the index lesion in the contralateral lobe. This information should be taken into account when hemiablative focal therapies are considered.

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Section: Discussionmentioning

confidence: 99%

Twelve Core Template Prostate Biopsy is an Unreliable Tool to Select Patients Eligible for Focal Therapy

Fumadó¹,

Rosell²,

Juanpere³

et al. 2015

Urol Int

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“…The patient also needs to be informed about the increased risk of a PSM if there is inadequate information from the prostate biopsy. Emerging techniques, including MRI for staging and MRI-targeted biopsies, may lead to a more accurate localization of cancer foci and help to reduce the risk for a PSM [27,28]. Unless these techniques become the standard of care, attempts should be made to establish rigid guidelines to further improve the quality of conventional prostate biopsies and their reporting.…”

Section: Discussionmentioning

confidence: 99%

Quality of Preoperative Biopsy Is a Risk Factor for Positive Surgical Margins in Organ-Confined Prostate Cancer Treated with Nerve-Sparing Robot-Assisted Radical Prostatectomy

Bütow

Schunk²,

Janssen³

et al. 2015

Urol Int

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Purpose: Positive surgical margins (PSM) during robot-assisted radical prostatectomy (RARP) negatively influence patients' prognosis. The aim of our study was to identify risk factors for PSM in patients with organ-confined prostate cancer (PCa). Methods: A clinical database of all patients that underwent a RARP at our institution was used. Uni- and multivariable logistic regression analyses were conducted on the PSM rates for all patients with organ-confined PCa. Results: Altogether, 1,600 patients were identified, including 1,085 organ-confined PCa with a PSM rate of 7.8%. On multivariable analysis, bilateral nerve-sparing (OR 3.025, 95% CI 1.587-5.765), surgeon volume <200 cases (OR 1.881, 95% CI 1.120-3.159) and a preoperative PSA >10 ng/ml (OR 3.674, 95% CI 1.379-9.796) remained independent prognostic factors. In a subgroup of patients undergoing a nerve-sparing RARP, the quality of the prostate biopsy (OR 2.398, 95% CI 1.325-4.341) was the sole independent risk factor for a PSM. Conclusion: An elevated preoperative PSA, surgical experience and a nerve-sparing procedure are all significantly associated with a higher risk for a PSM after RARP. For those undergoing a nerve sparing RARP, an accurate preoperative biopsy with detailed information on the location of positive cores is essential to prevent PSMs.

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“…Similar results were seen in another study of men with prior negative biopsy and elevated PSA. Kaufmann et al found that cancer detection rate was 20 % higher with fusion biopsy and all cancers identified by targeted biopsy met the criteria for significant cancer [30]. The ability of mp-MRI to identify significant cancer in men with prior negative biopsies was studied.…”

Section: Prior Negative Biopsymentioning

confidence: 99%

Optimizing Patient Population for MP-MRI and Fusion Biopsy for Prostate Cancer Detection

2015

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The diagnosis and treatment of prostate cancer continue to evolve with advances in science and technology. The utilization of multiparametric MRI (mp-MRI) to identify lesions in the prostate has given clinicians the ability to visualize malignancy in the prostate with greater confidence. With this new ability came the advancement of fusion biopsy platforms, which allow for direct targeting of these lesions. As with any new technology in medicine, the proper use of these modalities and how they fit into current clinical practice need to be addressed. This review summarizes the current knowledge on how to best optimize which men undergo mp-MRI and fusion biopsies both in the screening and treatment settings.

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Direct Comparison of Targeted MRI-Guided Biopsy with Systematic Transrectal Ultrasound-Guided Biopsy in Patients with Previous Negative Prostate Biopsies

Cited by 42 publications

References 23 publications

Twelve Core Template Prostate Biopsy is an Unreliable Tool to Select Patients Eligible for Focal Therapy

Twelve Core Template Prostate Biopsy is an Unreliable Tool to Select Patients Eligible for Focal Therapy

Quality of Preoperative Biopsy Is a Risk Factor for Positive Surgical Margins in Organ-Confined Prostate Cancer Treated with Nerve-Sparing Robot-Assisted Radical Prostatectomy

Optimizing Patient Population for MP-MRI and Fusion Biopsy for Prostate Cancer Detection

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