Value of Tracking Biopsy in Men Undergoing Active Surveillance of Prostate Cancer

Abstract

The tracking function of magnetic resonance imaging-ultrasound fusion biopsy warrants further study. When specific sites are resampled in men undergoing active surveillance of prostate cancer, upgrading is detected more often than by nontracking biopsy.

Magnetic Resonance Imaging–Guided Confirmatory Biopsy for Initiating Active Surveillance of Prostate Cancer

“…Studies previously have shown that tracked biopsies are able to return to a prior biopsy site within a few millimeters and are useful in the detection of upgrading. 16,19,36,37 Thus, the value of tracked biopsy, which has been studied little compared with targeting biopsy, deserves further evaluation in prospective trials.…”

“…Samples from the core coordinates that were found to have cancer cells were obtained again with tracked biopsy during follow-up to monitor for disease progression (Figure 1). 19 All biopsies were performed by a coauthor (L.S.M. ).…”

Use of MRI-Guided Biopsy for Selection and Follow-up of Men Undergoing Hemi-gland Cryoablation of Prostate Cancer

“…All patients underwent systematic 12-core biopsy and, when an MRI-visible lesion was present, targeted biopsy. All biopsy sites were tracked within the Artemis device, as described previously 21 . We calculated the change in prostate-specific antigen (PSA), prostate volume and PSA density (PSAD) from baseline to 6-month follow-up for each patient, and conducted a Wilcoxon rank sum test to determine significance of changes.…”

“…In the present study, biopsy follow-up, also MRI-guided, was mandated in the protocol and completed in 28/29 patients. Tracking of biopsy sites, a function of fusion devices, enables re-sampling of previous cancer foci, within or without of MRI-visible lesions 21,26 , and was used routinely to increase sensitivity of follow-up biopsy. Few prior studies of cryoablation have employed a protocol mandating a follow-up biopsy, and according to a recent literature review 25 , none by MRI-guided biopsy before and after treatment.…”

The use of prostate MR for targeting prostate biopsies

“… 47 Clinically, tracking is highly important as it may double the sensitivity for tumor upgrading on repeat biopsy. 48 …”