Transperineal Free-hand mpMRI Fusion-targeted Biopsies Under Local Anesthesia: Technique and Feasibility From a Single-center Prospective Study

Marra, Giancarlo; Marquis, Alessandro; Tappero, Stefano; D’Agate, D.; Oderda, Marco; Calleris, Giorgio; Falcone, Marco; Faletti, Riccardo; Molinaro, Luca; Zitella, Andrea; Bergamasco, Laura; Gontero, Paolo

doi:10.1016/j.urology.2019.11.078

Cited by 22 publications

(64 citation statements)

References 25 publications

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“…Ultrasonography images and fusion of ultrasonography and mpMRI images were performed using the Esaote platform (Esaote MyLab Machine class C, NaviSuite 5.0; Esaote, Genova, IT, for the Italian patients, and Esaote Real Time Virtual Sonography, Hitachi Medical Corporation, Tokyo, Japan, for the Chinese patients). The TP technique has been previously described [13]. Briefly, after performing TPFBx (median [interquartile range] 2 [2][3][4] cores per target), a minimum of 10 systematic cores were taken in the posterior peripheral zone (in each lobe apex, mid, basal sectors at the lateral and paramedian aspects), with the skin being punctured each time a core was taken [13].…”

Section: Biopsy Techniquementioning

confidence: 99%

“…The TP technique has been previously described [13]. Briefly, after performing TPFBx (median [interquartile range] 2 [2][3][4] cores per target), a minimum of 10 systematic cores were taken in the posterior peripheral zone (in each lobe apex, mid, basal sectors at the lateral and paramedian aspects), with the skin being punctured each time a core was taken [13].…”

Section: Biopsy Techniquementioning

confidence: 99%

“…These studies were mainly retrospective, however, potentially missing complications. Furthermore, they often included a limited number of patients [9][10][11], were performed at single institutions using different techniques [9][10][11][12][13] or did not evaluate important aspects, including pain and/or impact on erectile and urinary function [9][10][11]. Stefanova et al [12] reported only pain outcomes for more than 1000 non-MRI-targeted biopsies.…”

Section: Introductionmentioning

confidence: 99%

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Transperineal freehand multiparametric MRI fusion targeted biopsies under local anaesthesia for prostate cancer diagnosis: a multicentre prospective study of 1014 cases

et al. 2020

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To assess the outcomes of multiparametric magnetic resonance imaging (mpMRI) transperineal targeted fusion biopsy (TPFBx) under local anaesthesia. Patients and Methods We prospectively screened 1327 patients with a positive mpMRI undergoing TPFBx (targeted cores and systematic cores) under local anaesthesia, at two tertiary referral institutions, between September 2016 and May 2019, for inclusion in the present study. Primary outcomes were detection of clinically significant prostate cancer (csPCa) defined as (1) International Society of Urological Pathologists (ISUP) grade >1 or ISUP grade 1 with >50% involvement of prostate cancer (PCa) in a single core or in >2 cores (D1) and (2) ISUP grade >1 PCa (D2). Secondary outcomes were: assessment of peri-procedural pain (numerical rating scale [NRS]) and procedure timings; erectile (International Index of Erectile Function) and urinary (International Prostate Symptom Score) function changes; and complications. We also investigated the value of systematic sampling and concordance with radical prostatectomy (RP). Results A total of 1014 patients were included, of whom csPCa was diagnosed in 39.4% (n = 400). The procedure was tolerable (NRS pain score 3.1 AE 2.3), with no impact on erectile (P = 0.45) or urinary (P = 0.58) function, and a low rate of complications (Clavien-Dindo grades 1 or 2, n = 8; grade >2, n = 0). No post-biopsy sepsis was recorded. Twenty-two men (95% confidence interval [CI] 17-29) needed to undergo additional systematic biopsy to diagnose one csPCa missed by targeted biopsies (D1). ISUP grade concordance of biopsies with RP was as follows: k = 0.40 (95% CI 0.31-0.49) for targeted cores alone and k = 0.65 (95% CI 0.57-0.72; P < 0.05) overall. Conclusions The use of TPFBx under local anaesthesia yielded good csPCa detection and was feasible, quick, well tolerated and safe. Infectious risk was negligible. Addition of systematic to targeted cores may not be needed in all men, although it improves csPCa detection and concordance with RP.

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Section: Biopsy Techniquementioning

confidence: 99%

Section: Biopsy Techniquementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Transperineal freehand multiparametric MRI fusion targeted biopsies under local anaesthesia for prostate cancer diagnosis: a multicentre prospective study of 1014 cases

et al. 2020

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“…В отличие от биопсии in-bore выполнение аппаратной мпМРТ/ТРУЗИ fusion-биопсии занимает существенно меньше времени, в среднем 19-30 мин [62,68].…”

Section: ультразвуковая диагностика рака предстательной железыunclassified

The role of targeted biopsy methods in the prostate cancer diagnosis

et al. 2021

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The current prostate cancer screening program results in unnecessary biopsies in a quarter of patients, overdiagnosis of clinically insignificant prostate cancer (ISUP 1) and overtreatment. Intoducing multiparametric magnetic resonance imaging into routine practice before biopsy allows to decrease the number of biopsies, thereby reducing the burden on clinicians and increasing the likelihood of detecting clinically significant forms of prostate cancer (ISUP >2). The objective of this literature review is to compare targeted biopsy techniques and to determine their current role in the prostate cancer diagnosis.

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“…The TBx can be achieved through a transrectal or transperineal route. Both approaches are equivalent for patient tolerability and PCa detection rates in an SBx setting, with slight differences in infectious and retention complications [ 8 , 9 , 10 ]. However, the comparison in cancer detection rate (CDR) in a TBx configuration remains unclear.…”

Section: Introductionmentioning

confidence: 99%

Multiparametric Magnetic Resonance Imaging-Ultrasound Fusion Transperineal Prostate Biopsy: Diagnostic Accuracy from a Single Center Retrospective Study

Fulco

Chiaradia²,

Ascalone³

et al. 2021

Cancers

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The management of prostate biopsy in men with clinical suspicion of prostate cancer has changed in the last few years, especially with the introduction of imaging techniques, to overcome the low efficacy of risk stratification based on PSA levels. Here, we aimed to compare the diagnostic accuracy of multiparametric MRI with fusion ultrasound-guided prostate biopsy and standard biopsy, both performed through the transperineal route. To this end, we retrospectively analyzed 272 patients who underwent combined transperineal targeted and standard biopsy during the same session. The primary outcome was to compare the cancer detection rate between targeted and standard biopsy. The secondary outcome was to evaluate the added value of combined targeted and standard biopsy approach as compared to only targeted or standard biopsy. Results showed that a rate of 16.7% clinically significant tumors (International Society of Urological Pathology (ISUP) grade ≥ 2) would have been lost if only the standard biopsy had been used. The combined targeted and standard biopsy showed an added value of 10.3% and 9.9% in reducing the risk of prostate cancer missing after targeted or standard biopsy alone, respectively. The combined targeted and standard biopsy pathway is recommended to reduce the risk of missing clinically significant prostate cancer.

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Transperineal Free-hand mpMRI Fusion-targeted Biopsies Under Local Anesthesia: Technique and Feasibility From a Single-center Prospective Study

Cited by 22 publications

References 25 publications

Transperineal freehand multiparametric MRI fusion targeted biopsies under local anaesthesia for prostate cancer diagnosis: a multicentre prospective study of 1014 cases

Transperineal freehand multiparametric MRI fusion targeted biopsies under local anaesthesia for prostate cancer diagnosis: a multicentre prospective study of 1014 cases

The role of targeted biopsy methods in the prostate cancer diagnosis

Multiparametric Magnetic Resonance Imaging-Ultrasound Fusion Transperineal Prostate Biopsy: Diagnostic Accuracy from a Single Center Retrospective Study

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