Targeted transperineal biopsy of the prostate has limited additional benefit over background cores for larger MRI-identified tumors
Koo, Brendan C
World Journal of Urology
MetadataShow full item record
Barrett, T., Patterson, A., Koo, B. C., Wadhwa, K., Warren, A., Doble, A., Gnanapragasam, V., et al. (2015). Targeted transperineal biopsy of the prostate has limited additional benefit over background cores for larger MRI-identified tumors. World Journal of Urology https://doi.org/10.1007/s00345-015-1650-0
Purpose To compare histological outcomes in patients undergoing MRI-transrectal ultrasound fusion transperineal (MTTP) prostate biopsy and determine the incremental benefit of targeted cores. Methods 76 consecutive patients with 89 MRI-identified targets underwent MTTP biopsy. Separate targeted biopsies and background cores were obtained according to a standardized protocol. Target biopsies were considered of added diagnostic value if these cores showed a higher Gleason grade than non-targeted cores taken from the same sector (Group 1, n = 41). Conversely, where background cores demonstrated an equal or higher Gleason grade, target cores were considered to be non-beneficial (Group 2, n = 48). Results There was no significant difference in age, PSA, prostate volume, time-to-biopsy, or number of cores obtained between the groups. A greater proportion of target cores were positive for cancer (158/228; 69.3%) compared to background (344/1881; 18.38%). The median target volume was 0.54 cm^3 for Group 1 (range 0.09 - 2.79 cm^3), and 1.65 cm^3 for Group 2 (0.3 - 9.07 cm^3); p <0.001. The targets in Group 1 had statistically lower diameters for short and long axes, even after correction for gland size. The highest area under the receiver operating characteristic curve was demonstrated when a lesion cut-off value of 1.0 cm in short axis was applied, resulting in a sensitivity of 83.3% and specificity of 82.9%. Conclusions When a combined systematic and targeted transperineal prostate biopsy is performed, there is limited benefit in acquiring additional cores from larger volume targets with a short axis diameter greater than 1.0 cm.
Image-Guided Biopsy, Magnetic Resonance Imaging, Ultrasound, Transperineal, Prostate Cancer
The authors acknowledge research support from Cancer Research UK, National Institute of Health Research Cambridge Biomedical Research Centre, Cancer Research UK and the Engineering and Physical Sciences Research Council Imaging Centre in Cambridge and Manchester and the Cambridge Experimental Cancer Medicine Centre.
Cancer Research UK (16628)
PROSTATE CANCER UK (PA14-012)
External DOI: https://doi.org/10.1007/s00345-015-1650-0
This record's URL: https://www.repository.cam.ac.uk/handle/1810/249067
Creative Commons Attribution 4.0
Licence URL: http://creativecommons.org/licenses/by/4.0/