Evaluation of In-Office MRI/US Fusion Transperineal Prostate Biopsy via Free-hand Device during Routine Clinical Practice

Briggs, Logan; Kim, Michelle; Gusev, Andrew; Rumpf, Florian; Feldman, Adam S.; McGovern, Francis J.; Tabatabaei, Shahin; Dahl, Douglas M.

doi:10.1016/j.urology.2021.04.040

Cited by 10 publications

(5 citation statements)

References 23 publications

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“…Of these, 17 (18%) met inclusion criteria and underwent full‐text analysis (Figure S1 ). One study 24 was excluded from the pooled analysis of CDRs due to overlapping patients with a subsequently published report 13 that included a larger sample size. However, only the earlier of the two reports included data on procedural complications and so was included in our analysis of this endpoint.…”

Section: Resultsmentioning

confidence: 99%

“…In recent years, the limitations of the original freehand technique for performing transperineal prostate biopsy have been overcome by the introduction of a purpose‐built, probe‐mounted needle guide that includes a common access cannula known as the PrecisionPoint Transperineal Access System (Perineologic, Cumberland, MD). 5 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 Following its approval by the United States Food and Drug Administration in 2016, this device facilitated the rapid adoption of transperineal prostate biopsy worldwide and led to widespread calls for the complete abandonment of the transrectal approach to prostate biopsy. 25 , 26 In this report, we provide the results of a systematic review of the available literature on the outcomes and complications of performing transperineal prostate biopsies using this novel device.…”

Section: Introductionmentioning

confidence: 99%

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Pooled outcomes of performing freehand transperineal prostate biopsy with the PrecisionPoint Transperineal Access System

et al. 2022

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Objectives: To report the results of a pooled analysis evaluating the cancer detection rates, complications, and tolerability of prostate biopsies performed using the Preci-sionPoint Transperineal Access System. Patients and Methods:The medical literature was reviewed to identify studies published prior to 1 October 2021 evaluating the PrecisionPoint device for performance of transperineal prostate biopsy. Pooled analyses were performed to assess overall and clinically significant cancer detection rates. Additionally, data on complications as well as patient tolerability of the procedure when performed under local anaesthesia were extracted.Results: Transperineal biopsy with the PrecisionPoint Transperineal Access System achieved overall and clinically significant cancer detection rates of 67.9% and 42.6%, respectively. Among patients with Prostate Imaging Reporting and Data System 3, 4, and 5 lesions on prostate magnetic resonance imaging, clinically significant disease was found in 31.7%, 55.7%, and 71.8% of patients, respectively. Complications were rare, with sepsis reported in 4 (0.1%) of 3411 procedures despite frequent omission of antibiotic prophylaxis. Patients reported acceptable tolerability of the procedure when performed under local anaesthesia.Conclusions: Within the available medical literature, there is uniform evidence supporting the use of the PrecisionPoint Transperineal Access System for performing prostate biopsy procedures. The reported cancer detection and infectious complication rates with this device are in line with other methods for performing transperineal prostate biopsy. A unique aspect of the PrecisionPoint device is its ability to facilitate performing transperineal prostate biopsy under local anaesthesia. This factor will likely lead to increased adoption of the beneficial transperineal approach to prostate biopsy.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Pooled outcomes of performing freehand transperineal prostate biopsy with the PrecisionPoint Transperineal Access System

et al. 2022

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“…The regions of the 20-core TP biopsy scheme used in our study [ 16 ] were grouped into 10 areas: right anterior medial, right anterior lateral, right posterior medial, right posterior lateral, right base, left anterior medial, left anterior lateral, left posterior medial, left posterior lateral, and left base, based on laterality (right and left, anterior/posterior, middle/lateral, and base or non-base). Two cores were taken from each region according to the standard template, for a total of 20 cores.…”

Section: Discussionmentioning

confidence: 99%

Detection of extraprostatic extension by transperineal multiparametric magnetic resonance imaging-ultrasound fusion targeted combined with systemic template prostate biopsy

Chuang,

Wu,

Lin

et al. 2023

Diagn Pathol

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Background Extraprostatic extension (EPE) of prostate cancer (PCa) on transrectal (TR) needle core biopsy (Bx) is a rare histopathological finding that can help in clinical decision-making. The detection efficiency of the transperineal (TP) approach is yet to be explored. Methods We retrospectively reviewed 2848 PCa cases using concomitant systemic template biopsy (SBx) and multiparametric magnetic resonance imaging (MRI)-ultrasound fusion-targeted biopsy (TBx) using the TR (n = 1917) or TP (n = 931) approach at our institution between January 2015 and July 2022. We assessed and compared clinical, MRI, and biopsy characteristics using different approaches (TP and TR) and methods (SBx and TBx). Results In total, 40 EPE cases were identified (40/2848, 1.4%). TP showed a significantly higher EPE detection rate compared to TR in SBx (TR:0.7% vs. TP:1.6%; p = 0.028) and TBx (TR:0.5% vs. TP:1.2%; p = 0.033), as well as the combined methods (2.1% vs. 1.1%, p = 0.019). A significantly higher incidence of EPEs was found at non-base sites in TP than in TR (76.7% vs. 50%, p = 0.038). SBx showed a higher EPE detection rate than TBx; however, the difference was not statistically significant. TP showed higher prostate-specific antigen density (0.35 vs. 0.17, p = 0.005), higher frequency of GG4-5 in the cores with EPE (65.0% vs. 50.0%, p = 0.020), and more PCa-positive SBx cores (10 vs. 8, p = 0.023) compared to the TR. Conclusions TP may improve EPE detection compared with TR and should be applied to patients with adverse pre-biopsy features.

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“…The standard 20-core template biopsy was described in our previous study. 19 TP biopsy cores were obtained using a disposable 18-gauge 20 cm biopsy gun (Bard® biopsy system) under biplanar ultrasound visualization (BK Medical, Peabody, Massachusetts). All patients underwent 3–4 targeted biopsy cores followed by concomitant standard template biopsies.…”

Section: Methodsmentioning

confidence: 99%

Transperineal Multiparametric Magnetic Resonance Imaging–Ultrasound Fusion Targeted Prostate Biopsy Combined with Standard Template Improves Prostate Cancer Detection

Kim

Lin

et al. 2022

Journal of Urology

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Purpose: Transperineal (TP) prostate biopsy provides an effective approach to prostate cancer (PCa) detection. Although transrectal targeted biopsy has been well described, the specific advantage of the standard TP template or TP targeted biopsy using multiparametric (mp) magnetic resonance imaging (MRI)ultrasound (US) fusion remains less understood and without consensus. Materials and Methods: We identified all men who underwent a transperineal standard 20-core template in addition to a targeted biopsy with mpMRI-US fusionguided software from September 2019 to February 2021. We assessed and compared clinical, MRI and biopsy characteristics between standard TP template and fusion targeted biopsies. Results: A total of 301 men underwent TP fusion biopsy during the study period. Target lesions on MRI were sampled with 3 targeted cores per patient (IQR 3e4). The overall cancer detection rate was 74.1% and 63.5% by standard template and targeted biopsy, respectively, of which 52.5% and 59.7% were clinically significant (cs) PCa. Combined csPCa detection rate was 62.2%. Of 176 cases with a cancer diagnosis by both biopsy methods, 18.8% were upgraded with targeted biopsies while 18.2% were upgraded with template biopsies. Conclusions: In men with suspicious lesions on mpMRI, TP MRI fusion-guided biopsies combined with standard template provide a higher overall cancer detection rate and higher detection rate of csPCa than the standard template or targeted biopsy alone. In the setting of a suspicious mpMRI prostate lesion, targeted plus standard template should be included as part of the TP biopsy procedure.

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Evaluation of In-Office MRI/US Fusion Transperineal Prostate Biopsy via Free-hand Device during Routine Clinical Practice

Cited by 10 publications

References 23 publications

Pooled outcomes of performing freehand transperineal prostate biopsy with the PrecisionPoint Transperineal Access System

Pooled outcomes of performing freehand transperineal prostate biopsy with the PrecisionPoint Transperineal Access System

Detection of extraprostatic extension by transperineal multiparametric magnetic resonance imaging-ultrasound fusion targeted combined with systemic template prostate biopsy

Transperineal Multiparametric Magnetic Resonance Imaging–Ultrasound Fusion Targeted Prostate Biopsy Combined with Standard Template Improves Prostate Cancer Detection

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