Systematic review and meta-analysis comparing cognitive vs. image-guided fusion prostate biopsy for the detection of prostate cancer

Watts, Kara; Frechette, Laena; Muller, Ben; Ilinksy, Dan; Kovac, Evan; Sankin, Alex; Aboumohamed, Ahmed

doi:10.1016/j.urolonc.2020.03.020

Cited by 44 publications

(36 citation statements)

References 26 publications

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“…Fourth, the same biopsy modality was not used to compare radiologists A and B in terms of tumor targeting. Recent meta-analysis reported that there is no difference between MRI-TRUS cognitive fusion and MRI-TRUS image fusion biopsies in terms of cancer detection rate (26). Our study showed no significant difference between A and B in terms of cancer detection rate, either.…”

Section: Discussioncontrasting

confidence: 66%

New TRUS Techniques and Imaging Features of PI-RADS 4 or 5: Influence on Tumor Targeting

Chang

Park

2021

Front. Oncol.

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PurposeTo determine if the new transrectal ultrasound (TRUS) techniques and imaging features contribute to targeting Prostate Imaging and Reporting and Data System (PI-RADS) 4 or 5.Materials and MethodsBetween December 2018 and February 2020, 115 men underwent cognitive biopsy by radiologist A, who was familiar with the new TRUS findings and biopsy techniques. During the same period, 179 men underwent magnetic resonance imaging–TRUS image fusion or cognitive biopsy by radiologist B, who was unfamiliar with the new biopsy techniques. Prior to biopsy, both radiologists knew MRI findings such as the location, size, and shape of PI-RADS 4 or 5. We recorded how many target biopsies were performed without systematic biopsy and how many of these detected higher Gleason score (GS) than those detected by systematic biopsy. The numbers of biopsy cores were also obtained. Fisher Exact or Mann–Whitney test was used for statistical analysis.ResultsFor PI-RADS 4, target biopsy alone was performed in 0% (0/84) by radiologist A and 0.8% (1/127) by radiologist B (p>0.9999). Target biopsy yielded higher GSs in 57.7% (30/52) by radiologist A and 29.5% (23/78) by radiologist B (p = 0.0019). For PI-RADS 5, target biopsy alone was performed in 29.0% (9/31) by radiologist A and 1.9% (1/52) by radiologist B (p = 0.0004). Target biopsy yielded higher GSs in 50.0% (14/28) by radiologist A and 18.2% (8/44) by radiologist B (p = 0.0079). Radiologist A sampled fewer biopsy cores than radiologist B (p = 0.0008 and 0.0023 for PI-RADS 4 and 5), respectively.ConclusionsPI-RADS 4 or 5 can be more precisely targeted if the new TRUS biopsy techniques are applied.

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Section: Discussioncontrasting

confidence: 66%

New TRUS Techniques and Imaging Features of PI-RADS 4 or 5: Influence on Tumor Targeting

Chang

Park

2021

Front. Oncol.

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“… 26 We developed and piloted a coordinate-based approach to support cognitive targeted prostate biopsies, demonstrating comparable clinically significant cancer detection rates to other published series. 27 Our hope is that our coordinate-based approach may reduce the “variability” of targeting lesions during cognitive prostate biopsy and “flatten” the learning curve.…”

Section: Discussionmentioning

confidence: 99%

Developing a coordinate-based strategy to support cognitive targeted prostate biopsies and correlative spatial-histopathological outcome analysis

Clement

Day

Rooney

et al. 2021

Asian Journal of Andrology

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Lack of investment for magnetic resonance (MR) fusion systems is an obstacle to deliver targeted prostate biopsies within the prostate cancer diagnostic pathway. We developed a coordinate-based method to support cognitive targeted prostate biopsies and then performed an audit on cancer detection and the location of lesions. In each patient, the prostate is considered as two separate hemiprostates, and each hemiprostate is divided into 4 × 4 × 4 units. Each unit is therefore defined by a three-dimensional coordinate. We prospectively applied our coordinates approach to target 106 prostatic lesions in 93 men. Among 45 (of 106; 42.5%) lesions positive for cancer, 27 lesions (60.0%) harbored clinically significant disease. PSA density was significantly higher in patients with proven cancer (median: 0.264 ng ml −2 ) when compared to the noncancer group (median: 0.145 ng ml −2 ; P = 0.003, Wilcoxon rank-sum test). Lesions with Prostate Imaging-Reporting and Data System (PIRADS) score of 5 were found to have a cancer incidence of 65.2%, while PIRADS 4 and 3 lesions have a lower risk of cancer detection, as expected, at 37.3% and 31.3%, respectively. The probability of a lesion being cancerous in our series significantly decreases as we go from the “apex-to-base” dimension (odds ratio [OR]: 2.62, 95% confidence interval [CI]: 1.55–4.44, P = 0.00034). Our analysis also indicates that the probability of cancer decreases as the prostate volume increases (OR: 1.03, 95% CI: 1.01–1.05, P = 0.00327). Based on this feasibility study, the use of coordinates to guide cognitive targeted prostate biopsies warrants future validation study in additional centers.

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“…34,35 Even though fusion biopsies are promising there appears to be no clear advantage in detection rate compared with cognitive biopsies, 36 as these methods show comparable results and no statistically significant difference. 37 Looking at similar sample sizes of two different studies, Zhang et al's freehand Esaote fusion TP biopsy 38 and Neale et al's freehand PrecisionPoint cognitive MRI TP biopsy, 39 cognitive MRI biopsy shows better detection rate (84% compared with 50.45%) and CSD detection (69% compared with 44.2%). Nevertheless, Oderda et al, comparing the two methods with 50 patients randomised into KOELIS fusion or cognitive biopsy, suggest that fusion may have a role in better detection of prostate cancer for lesions ≤10 mm.…”

Section: Fusionmentioning

confidence: 98%

Recent Advances in Systematic and Targeted Prostate Biopsies

Devetzis¹,

Kum²,

Popert³

2021

RRU

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Systematic review and meta-analysis comparing cognitive vs. image-guided fusion prostate biopsy for the detection of prostate cancer

Cited by 44 publications

References 26 publications

New TRUS Techniques and Imaging Features of PI-RADS 4 or 5: Influence on Tumor Targeting

New TRUS Techniques and Imaging Features of PI-RADS 4 or 5: Influence on Tumor Targeting

Developing a coordinate-based strategy to support cognitive targeted prostate biopsies and correlative spatial-histopathological outcome analysis

Recent Advances in Systematic and Targeted Prostate Biopsies

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