Recent Advances in Systematic and Targeted Prostate Biopsies

Devetzis, Konstantinos; Kum, Francesca; Popert, R.

doi:10.2147/rru.s291963

Cited by 11 publications

(17 citation statements)

References 56 publications

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“…In the UK men referred with either of these abnormalities usually undergo a multiparametric MRI (mpMRI) followed by a prostate biopsy [1,2]. Over the last three decades prostate biopsy techniques under local anaesthetic (LA) in the clinic setting have become increasingly refined [3], progressing from digitally guided 'Tru-Cut' biopsies to TRUS-guided systematic biopsies, to targeting of MRI-visible lesions with or without systematic cores. Refinements of TRUS biopsy during this time [3] have included use of LA [4], povidone-iodine rectal cleansing [5], rectal swabs to guide antibiotic prophylaxis [6], appropriate use of antibiotic prophylaxis based on local microbiology guidelines and microbial resistance patterns [7], standardisation of the appropriate numbers of prostate biopsy cores with which to sample the prostate based on gland volume [8], and use of pre-biopsy mpMRI [2], along with targeted biopsy based on cognitive or image-fusion guidance [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Protocol for the TRANSLATE prospective, multicentre, randomised clinical trial of prostate biopsy technique

et al. 2023

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Objectives Primary objectives: to determine whether local anaesthetic transperineal prostate (LATP) biopsy improves the detection of clinically significant prostate cancer (csPCa), defined as International Society of Urological Pathology (ISUP) Grade Group ≥2 disease (i.e., any Gleason pattern 4 disease), compared to transrectal ultrasound‐guided (TRUS) prostate biopsy, in biopsy‐naïve men undergoing biopsy based on suspicion of csPCa. Secondary objectives: to compare (i) infection rates, (ii) health‐related quality of life, (iii) patient‐reported procedure tolerability, (iv) patient‐reported biopsy‐related complications (including bleeding, bruising, pain, loss of erectile function), (v) number of subsequent prostate biopsy procedures required, (vi) cost‐effectiveness, (vii) other histological parameters, and (viii) burden and rate of detection of clinically insignificant PCa (ISUP Grade Group 1 disease) in men undergoing these two types of prostate biopsy. Patients and Methods The TRANSLATE trial is a UK‐wide, multicentre, randomised clinical trial that meets the criteria for level‐one evidence in diagnostic test evaluation. TRANSLATE is investigating whether LATP biopsy leads to a higher rate of detection of csPCa compared to TRUS prostate biopsy. Both biopsies are being performed with an average of 12 systematic cores in six sectors (depending on prostate size), plus three to five target cores per multiparametric/bi‐parametric magnetic resonance imaging lesion. LATP biopsy is performed using an ultrasound probe‐mounted needle‐guidance device (either the ‘Precision‐Point’ or BK UA1232 system). TRUS biopsy is performed according to each hospital's standard practice. The study is 90% powered to detect a 10% difference (LATP biopsy hypothesised at 55% detection rate for csPCa vs 45% for TRUS biopsy). A total of 1042 biopsy‐naïve men referred with suspected PCa need to be recruited. Conclusions This trial will provide robust prospective data to determine the diagnostic ability of LATP biopsy vs TRUS biopsy in the primary diagnostic setting.

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Section: Introductionmentioning

confidence: 99%

Protocol for the TRANSLATE prospective, multicentre, randomised clinical trial of prostate biopsy technique

et al. 2023

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“…It has been recommended to obtain 24–36 core systematic biopsies in the anterior, mid and posterior sectors of the peripheral zones [ 7 ]. This is supplemented by the use of devices such as the PrecisionPointTM TP Access System which allows limited penetration of perineal skin and also aligns the biopsy needle to the ultrasound array [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

The design and validation of a low-cost trans perineal (TP) prostate biopsy simulator for training: improving trainees’ confidence and cognitive targeting skills

et al. 2023

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Purpose The aim of this research was to create a novel and low-cost TP prostate biopsy simulator that has face, content and construct validity with high educational value. Methods This research developed a trans perineal prostate (TP) biopsy simulator using 3D-printed moulds and tissue-mimicking materials. Important regions (anterior, mid, and posterior zones) were coded with different colours. Ultrasound visible abnormal lesions were embedded in the prostate phantom. Expert and novice participants in TP biopsies were recruited. Essential skills were identified through the consensus of six experts. These skills were assessed through tasks performed by participants. This included the accuracy and timing of systematic and target biopsies. Immediate feedback was determined by the colour of the biopsy cores taken. A survey was distributed to evaluate its realism and educational value. Results The material cost of one simulator was £7.50. This simulator was proven to have face, content, and construct validity. There was a significant difference ( p = 0.02) in the accuracy of systematic biopsies between both experts and novices. Significant difference was also observed ( p = 0.01), in accurately identifying target lesion on ultrasound between both groups. Participants rated the overall realism of the simulator 4.57/5 (range 3–5). 100% of the experts agreed that introducing this simulator to training will be beneficial. 85.7% of the participants strongly agree that the simulator improved their confidence in TP biopsies. Conclusion There is value in integrating this proof-of-concept TP prostate biopsy simulator into training. It has highly rated educational value and has face, content, and construct validity. Supplementary Information The online version contains supplementary material available at 10.1007/s00345-023-04387-y.

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“… 9 , 10 With improved access to hard-to-reach portions of the prostate gland and minimal infection rates, TP-Bx has re-emerged positioning itself as the solution to these problems. 11 – 14 …”

Section: Introductionmentioning

confidence: 99%

“…9,10 With improved access to hard-to-reach portions of the prostate gland and minimal infection rates, TP-Bx has reemerged positioning itself as the solution to these problems. [11][12][13][14] While TP-Bx is increasingly being used, there is a considerable variation in transperineal templateguided biopsy schemes used among clinicians. The absence of consensus highlights the need for evidence-based recommendations to optimize cancer detection.…”

Section: Introductionmentioning

confidence: 99%

Schema and cancer detection rates for transperineal prostate biopsy templates: a review

Sidana

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Wang

et al. 2022

Therapeutic Advances in Urology

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Prostate cancer (PCa) is the most common noncutaneous malignancy in men and is the second leading cause of cancer mortality in men in the United States. Current practice requires histopathological confirmation of cancer achieved through biopsy for diagnosis. The transrectal approach for prostate biopsy has been the standard for several decades. However, the risks and limitations of transrectal biopsies have led to a recent resurgence of transperineal prostatic biopsies. Recent studies have demonstrated the transperineal approach for prostate biopsies to be effective, associated with minimal complications and superior in several aspects to traditional transrectal biopsies. While sextant and extended sextant templates are widely accepted templates for transrectal biopsy, there are a diverse set of transperineal biopsy templates available for use, without consensus on the optimal sampling strategy. We aim to critically appraise the salient features of established transperineal biopsy templates.

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Recent Advances in Systematic and Targeted Prostate Biopsies

Cited by 11 publications

References 56 publications

Protocol for the TRANSLATE prospective, multicentre, randomised clinical trial of prostate biopsy technique

Protocol for the TRANSLATE prospective, multicentre, randomised clinical trial of prostate biopsy technique

The design and validation of a low-cost trans perineal (TP) prostate biopsy simulator for training: improving trainees’ confidence and cognitive targeting skills

Schema and cancer detection rates for transperineal prostate biopsy templates: a review

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