The Learning Curve for Magnetic Resonance Imaging/Ultrasound Fusion-guided Prostate Biopsy

Kasabwala, Khushabu; Patel, Neal; Cricco-Lizza, Eliza; Shimpi, Adrian A.; Weng, Stanley; Buchmann, Rose M.; Motanagh, Samaneh; Wu, Yongwei; Banerjee, Samprit; Khani, Francesca; Margolis, Daniel; Robinson, Brian D.; Hu, Jim C.

doi:10.1016/j.euo.2018.07.005

Cited by 58 publications

(53 citation statements)

References 29 publications

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“…These findings are comparable with the report by Maxeiner et al [8], who reported CDRs of 67%, 70%, and 77% for TB alone, SB alone, and TB + SB, respectively. The slightly lower CDRs in our cohort may be related to differences in the biopsy learning curve, radiologists interobserver variability, or variability in the histological examination of prostate needle biopsies [17][18][19][20]. Moreover, these results clearly demonstrate that in biopsy-naïve patients, when TB is considered, due to available mpMRI information and a suspicion of PCa in mpMRI (PI-RADS 3), combined TB + SB increases not only the overall CDR, but also significant PCa detection rates.…”

Section: Discussionmentioning

confidence: 99%

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Performance of Combined Magnetic Resonance Imaging/Ultrasound Fusion-guided and Systematic Biopsy of the Prostate in Biopsy-naïve Patients and Patients with Prior Biopsies

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Wenzel

et al. 2021

European Urology Focus

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Section: Discussionmentioning

confidence: 99%

“…However, to reduce the selection bias, MRI for these patients was secondary classified according to PI-RADS v.2. Finally, interobserver and inter-reader variability between radiologists and differences in the TB learning curve could have influenced our results [17][18][19]30].…”

Section: Discussionmentioning

confidence: 99%

Performance of Combined Magnetic Resonance Imaging/Ultrasound Fusion-guided and Systematic Biopsy of the Prostate in Biopsy-naïve Patients and Patients with Prior Biopsies

Preißer

Theißen

Wenzel

et al. 2021

European Urology Focus

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“…A systematic review of the literature regarding the utility of mpMRI in AS shows varied results due to a lack of robust data, arising not only from heterogeneity in AS inclusion criteria and non-uniform mpMRI use [12,23], but more importantly from the lack of a standardised approach to document changes in prostate mpMRI findings over time in men followed on AS [24]. Moreover, in most of these studies the utility of mpMRI for detecting clinically significant PCa was assessed in terms of the yield of mpMRI-targeted biopsy alone, which could have been affected by the learning curve for this biopsy technique [25][26][27]. Thus, to better understand the added value of mpMRI in AS monitoring, we compared the risk of upgrading to GG ≥ 2 in AS men enrolled during a period when mpMRI was not used (1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012), to those men on AS who were enrolled and followed with a mpMRI.…”

Section: Discussionmentioning

confidence: 99%

Utility of multiparametric magnetic resonance imaging in the risk stratification of men with Grade Group 1 prostate cancer on active surveillance

et al. 2020

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ObjectiveTo assess if the adoption of multiparametric magnetic resonance imaging (mpMRI) in active surveillance (AS) has improved the identification of occult higher-grade prostate cancer (PCa). Patients and MethodsWe retrospectively identified men from the Johns Hopkins AS registry enrolled since 2013 (year of mpMRI adoption) with Grade Group (GG) 1 PCa and who underwent a single mpMRI. Men in this group were dichotomised by the presence (n = 207) or absence (negative mpMRI, n = 225) of one or more lesions with a Prostate Imaging-Reporting and Data System (PI-RADS) score of ≥ 3. Both groups were compared to a third cohort of men with GG1 PCa enrolled in AS prior to 2013 (pre-mpMRI era, n = 669). The risk of upgrading to GG ≥ 2 PCa on follow-up biopsies (performed with or without MRI targeting) was evaluated among the groups using survival analysis. ResultsMen in both mpMRI groups underwent a median (interquartile range [IQR]) of 2 (2-3) biopsies separated by a median (IQR) interval of 13 (12-16) months, whereas men in the pre-MRI era underwent a median (IQR) of 3 (2-5) biopsies, separated by a median (IQR) interval of 12 (12-14) months. The 2-and 4-year upgrade-free survival rates were 93% and 83%, 74% and 59%; and, 87% and 76% for the negative mpMRI, PI-RADS ≥ 3, and pre-mpMRI-era groups, respectively (P < 0.001). On multivariable analysis, both mpMRI groups had significantly different risk of upgrading compared to pre-mpMRI-era group (negative mpMRI group: hazard ratio [HR] 0.61, 95% confidence interval [CI] 0.39-0.95, P = 0.03; PI-RADS ≥ 3 group: HR 1.96, 95% CI 1.36-2.82, P < 0.001). ConclusionsmpMRI improves the risk stratification of men on AS and should be used to aid enrolment and monitoring decisions.

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“…However, besides the above mentioned higher detection rate, the availability of an mpMRI of the prostate has several other advances for patients undergoing RP, which were not tested in the present study (e.g., improvement of local T-stage evaluation, improvement of local therapeutic decision regarding nerve sparing) (21, 22). Despite the known advantages of TB, one has to keep in mind that urologists who perform TB have to undergo a certain learning curve (23).…”

Section: Discussionmentioning

confidence: 99%

MRI-Fusion Targeted vs. Systematic Prostate Biopsy–How Does the Biopsy Technique Affect Gleason Grade Concordance and Upgrading After Radical Prostatectomy?

et al. 2019

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Introduction: MRI-targeted biopsy (TB) increases overall prostate-cancer (PCa) detection-rates and decreases the risk of insignificant PCa detection. However, the impact of these findings on the definite pathology after radical prostatectomy (RP) is under debate.Materials and Methods: Between 01/2014 and 12/2018, 366 patients undergoing prostate biopsy and RP were retrospectively analyzed. The correlation between biopsy Gleason-score (highest Gleason-score in a core) and the RP Gleason-score in patients undergoing systematic biopsy (SB-group) (n = 221) or TB+SB (TB-group, n = 145) was tested using the ISUP Gleason-group grading (GGG, scale 1–5). Sub analyses focused on biopsy GGG 1 and GGG ≥ 2.Results: Proportions of biopsy GGG 1–5 in the SB-group and TB-group were 24.4, 37.6, 19, 10.9, 8.1% and 13.8, 43.4, 24.2, 13.8, 4.8%, respectively (p = 0.07). Biopsy and pathologic GGG were concordant in 108 of 221 (48.9%) in SB- and 74 of 145 (51.1%) in TB-group (p = 0.8). Gleason upgrading was recorded in 33.5 and 31.7% in SB- vs. TB-group (p = 0.8). Patients with biopsy GGG 1 undergoing RP showed an upgrading in 68.5%(37/54) in SB- and 75%(15/20) in TB-group (p = 0.8). In patients with biopsy GGG ≥ 2 concordance increased for both biopsy approaches (54.5 vs. 55.2% for SB- vs. TB-group, p = 0.9).Discussion: Irrespective of differences in PCa detection-rates between TB- and SB-groups, no significant differences in GGG concordance and upgrading between patients of both groups undergoing biopsy, followed by RP, were recorded. Concordance rates increased in men with biopsy GGG ≥ 2. TB seems to detect more patients with PCa without a difference in concordance with final pathology.

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The Learning Curve for Magnetic Resonance Imaging/Ultrasound Fusion-guided Prostate Biopsy

Cited by 58 publications

References 29 publications

Performance of Combined Magnetic Resonance Imaging/Ultrasound Fusion-guided and Systematic Biopsy of the Prostate in Biopsy-naïve Patients and Patients with Prior Biopsies

Performance of Combined Magnetic Resonance Imaging/Ultrasound Fusion-guided and Systematic Biopsy of the Prostate in Biopsy-naïve Patients and Patients with Prior Biopsies

Utility of multiparametric magnetic resonance imaging in the risk stratification of men with Grade Group 1 prostate cancer on active surveillance

MRI-Fusion Targeted vs. Systematic Prostate Biopsy–How Does the Biopsy Technique Affect Gleason Grade Concordance and Upgrading After Radical Prostatectomy?

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