Primary magnetic resonance imaging/ultrasonography fusion‐guided biopsy of the prostate

Maxeiner, Andreas; Kittner, Beatrice; Blobel, Conrad; Wiemer, Laura; Hofbauer, Sebastian L.; Fischer, Thomas; Asbach, Patrick; Haas, Matthias; Penzkofer, Tobias; Fuller, Florian; Miller, Kurt; Cash, Hannes

doi:10.1111/bju.14212

Cited by 38 publications

(34 citation statements)

References 35 publications

(63 reference statements)

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“…In contrast, the present study showed that TB without SB would have missed 7.3% (8/131) of csPCa compared with a combination of SB and TB. Previous studies also showed that 13% and 16% of significant cancers were missed by TB in comparison with a combination of SB and TB . Based on the current technologies and skillset, the present data support combining standard and targeted biopsy to ensure we do not miss significant cancers.…”

Section: Discussionsupporting

confidence: 73%

“…Previous studies also showed that 13% and 16% of significant cancers were missed by TB in comparison with a combination of SB and TB. 18,19 Based on the current technologies and skillset, the present data support combining standard and targeted biopsy to ensure we do not miss significant cancers. We carried out not only patient-based analyses, but also lesion-based and biopsy core-based analyses.…”

Section: Discussionmentioning

confidence: 63%

“…To evaluate the usefulness of initial MRI/US TB, a few studies focused on biopsy‐naïve patients . These studies also showed that MRI/US TB alone or combined with SB had equal or superior overall PCa and csPCa detection rates compared with the conventional standard biopsy.…”

Section: Discussionmentioning

confidence: 99%

“…1,2,4 To evaluate the usefulness of initial MRI/US TB, a few studies focused on biopsy-na€ ıve patients. [15][16][17][18] These studies also showed that MRI/US TB alone or combined with SB had equal or superior overall PCa and csPCa detection rates compared with the conventional standard biopsy. Recently, a randomized controlled trial was reported by Kasivisvanathan et al, and they showed MRI-TB alone was able to detect more csPCa (39% vs 27%) and less isPCa (9% vs 22%) than standard SB.…”

Section: Discussionmentioning

confidence: 99%

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Magnetic resonance imaging/transrectal ultrasonography fusion targeted prostate biopsy finds more significant prostate cancer in biopsy‐naïve Japanese men compared with the standard biopsy

et al. 2019

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Objective To assess the clinical benefits of magnetic resonance imaging/transrectal ultrasound fusion‐targeted biopsy for biopsy‐naïve Japanese men. Methods Between February 2017 and August 2018, 131 biopsy‐naïve men who underwent targeted biopsy together with 10‐core systematic biopsy at Hiroshima University Hospital were retrospectively investigated. Multiparametric magnetic resonance imaging findings were reported based on Prostate Imaging Reporting and Data System version 2. Results The overall cancer detection rates per patient were 69.5% in systematic biopsy + targeted biopsy cores, 61.1% in systematic biopsy cores and 61.1% in targeted biopsy cores. The detection rates for clinically significant prostate cancer were 43.5% in targeted biopsy cores and 35.9% in systematic biopsy cores (P = 0.04), whereas the detection rates for clinically insignificant prostate cancer were 17.6% and 25.2% respectively (P = 0.04). Lesions in the peripheral zone were diagnosed more with clinically significant prostate cancer (54.8% vs 20.7%, P < 0.001) and International Society of Urological Pathology grade (3.2 vs 2.7, P = 0.02) than that in the inner gland. Just 4.2% (3/71) of Prostate Imaging Reporting and Data System category 2 and 3 lesions in the middle or base of the inner gland were found to have clinically significant prostate cancer. The cancer detection rate per core was 42.3% in targeted biopsy cores, whereas it was 17.9% in systematic biopsy cores (P < 0.001). Conclusions Targeted biopsy is able to improve the diagnostic accuracy of biopsy in detection of clinically significant prostate cancer by reducing the number of clinically insignificant prostate cancer detections compared with 10‐core systematic biopsy in biopsy‐naïve Japanese men. In addition, the present findings suggest that patients with Prostate Imaging Reporting and Data System category 2 or 3 lesions at the middle or base of the inner gland might avoid biopsies.

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Section: Discussionsupporting

confidence: 73%

Section: Discussionmentioning

confidence: 63%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Magnetic resonance imaging/transrectal ultrasonography fusion targeted prostate biopsy finds more significant prostate cancer in biopsy‐naïve Japanese men compared with the standard biopsy

et al. 2019

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“…Additionally, the PRECISION trial implied the utility of MRI‐targeted biopsy without systematic biopsy . In this study, clinically significant cancer was missed in just 3% of all patients who underwent MRI‐targeted biopsy without systematic biopsy, whereas clinically significant cancer was missed in 7% and 10% of patients in other studies . Thus, the significance of systematic biopsy accompanied by MRI‐targeted biopsy in biopsy‐naïve men is controversial.…”

mentioning

confidence: 75%

Editorial Comment from Dr Shiota to Magnetic resonance imaging/transrectal ultrasonography fusion targeted prostate biopsy finds more significant prostate cancer in biopsy‐naïve Japanese men compared with the standard biopsy

Shiota

2019

Int J of Urology

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Comparison of Targeted vs Systematic Prostate Biopsy in Men Who Are Biopsy Naive

et al. 2019

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IMPORTANCE Magnetic resonance imaging (MRI) guidance improves the accuracy of prostate biopsy for the detection of clinically significant prostate cancer, but the optimal use of such guidance is not yet clear. OBJECTIVE To determine the cancer detection rate (CDR) of targeting MRI-visible lesions vs systematic prostate sampling in the diagnosis of clinically significant prostate cancer in men who were biopsy naive. DESIGN, SETTING, AND PARTICIPANTS This paired cohort trial, known as the Prospective Assessment of Image Registration in the Diagnosis of Prostate Cancer (PAIREDCAP) study, was conducted in an academic medical center from January 2015 to April 2018. Men undergoing first-time prostate biopsy were enrolled. Paired-cohort participants were a consecutive series of men with MRI-visible lesions (defined by a Prostate Imaging Reporting & Data System version 2 score Ն 3), who each underwent 3 biopsy methods at the same sitting: first, a systematic biopsy; second, an MRI-lesion biopsy targeted by cognitive fusion; and third, an MRI-lesion targeted by software fusion. Another consecutive series of men without MRI-visible lesions underwent systematic biopsies to help determine the false-negative rate of MRI during the trial period. MAIN OUTCOMES AND MEASURES The primary end point was the detection rate of clinically significant prostate cancer (Gleason grade group Ն2) overall and by each biopsy method separately. The secondary end points were the effects of the Prostate Imaging Reporting & Data System version 2 grade, prostate-specific antigen density, and prostate volume on the primary end point. Tertiary end points were the false-negative rate of MRI and concordance of biopsy-method results by location of detected cancers within the prostate. RESULTS A total of 300 men participated; 248 had MRI-visible lesions (mean [SD] age, 65.5 [7.7] years; 197 were white [79.4%]), and 52 were control participants (mean [SD] age, 63.6 [5.9] years; 39 were white [75%]). The overall CDR was 70% in the paired cohort group, achieved by combining systematic and targeted biopsy results. The CDR by systematic sampling was 15% in the group without MRI-visible lesions. In the paired-cohort group, CDRs varied from 47% (116 of 248 men) when using cognitive fusion biopsy alone, to approximately 60% when using systematic biopsy (149 of 248 men) or either fusion method alone (154 of 248 men), to 70% (174 of 248 men) when combining systematic and targeted biopsy. Discordance of tumor locations suggests that the different biopsy methods detect different tumors. Thus, combining targeting and systematic sampling provide greatest sensitivity for detection of clinically significant prostate cancer. For all biopsy methods, the Prostate Imaging Reporting & Data System version 2 grade and prostate-specific antigen density were directly associated with CDRs, and prostate volume was inversely associated. CONCLUSIONS AND RELEVANCE An MRI-visible lesion in men undergoing first-time prostate biopsy identifies those with a heightened risk of clinically ...

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Primary magnetic resonance imaging/ultrasonography fusion‐guided biopsy of the prostate

Cited by 38 publications

References 35 publications

Magnetic resonance imaging/transrectal ultrasonography fusion targeted prostate biopsy finds more significant prostate cancer in biopsy‐naïve Japanese men compared with the standard biopsy

Magnetic resonance imaging/transrectal ultrasonography fusion targeted prostate biopsy finds more significant prostate cancer in biopsy‐naïve Japanese men compared with the standard biopsy

Editorial Comment from Dr Shiota to Magnetic resonance imaging/transrectal ultrasonography fusion targeted prostate biopsy finds more significant prostate cancer in biopsy‐naïve Japanese men compared with the standard biopsy

Comparison of Targeted vs Systematic Prostate Biopsy in Men Who Are Biopsy Naive

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