The Quest for the Optimal Prostate Biopsy Regime for the 21st Century

Gnanapragasam, Vincent; Barrett, Tristan

doi:10.1016/j.eururo.2018.12.031

Cited by 2 publications

(2 citation statements)

References 9 publications

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“… 73 Of note, TP cognitive targeting may be more reliable than TR when using a fixed grid, as the main targeting error arises only in the Z-plane, whereas for TR approaches, errors in any plane are possible. 74 A multicentre cohort study showed that the image fusion technique may be superior in experienced hands. 75 However, none of the studies provided data on whether differences may relate to variables such as prostate size, lesion characteristics, operator expertise and type of anaesthesia.…”

Section: Introductionmentioning

confidence: 99%

Optimal biopsy approach for detection of clinically significant prostate cancer

Ippoliti

Fletcher

Orecchia

et al. 2021

The British Journal of Radiology

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Prostate cancer (PCa) diagnostic and therapeutic work-up has evolved significantly in the last decade, with pre-biopsy multiparametric MRI now widely endorsed within international guidelines. There is potential to move away from the widespread use of systematic biopsy cores and towards an individualised risk-stratified approach. However, the evidence on the optimal biopsy approach remains heterogeneous, and the aim of this review is to highlight the most relevant features following a critical assessment of the literature. The commonest biopsy approaches are via the transperineal (TP) or transrectal (TR) routes. The former is considered more advantageous due to its negligible risk of post-procedural sepsis and reduced need for antimicrobial prophylaxis; the more recent development of local anaesthetic (LA) methods now makes this approach feasible in the clinic. Beyond this, several techniques are available, including cognitive registration, MRI–Ultrasound fusion imaging and direct MRI in-bore guided biopsy. Evidence shows that performing targeted biopsies reduces the number of cores required and can achieve acceptable rates of detection whilst helping to minimise complications and reducing pathologist workloads and costs to health-care facilities. Pre-biopsy MRI has revolutionised the diagnostic pathway for PCa, and optimising the biopsy process is now a focus. Combining MR imaging, TP biopsy and a more widespread use of LA in an outpatient setting seems a reasonable solution to balance health-care costs and benefits, however, local choices are likely to depend on the expertise and experience of clinicians and on the technology available.

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Section: Introductionmentioning

confidence: 99%

Optimal biopsy approach for detection of clinically significant prostate cancer

Ippoliti

Fletcher

Orecchia

et al. 2021

The British Journal of Radiology

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“…Current evidence suggests that mp-MRI and targeted biopsy coupled with systematic biopsy is the most accurate way of identifying men with significant cancers at diagnosis 2–4. But how accurate are such approaches in picking up additional clinically significant cancers (Gleason Group≥2) within a prostate known already to harbour a cancer?…”

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confidence: 99%

Precision prostatectomy: reconciling functional and oncological outcomes

Neal

2019

BMJ Surg Interv Health Technologies

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The Quest for the Optimal Prostate Biopsy Regime for the 21st Century

Cited by 2 publications

References 9 publications

Optimal biopsy approach for detection of clinically significant prostate cancer

Optimal biopsy approach for detection of clinically significant prostate cancer

Precision prostatectomy: reconciling functional and oncological outcomes

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