Repository logo
 

Targeted transperineal biopsy of the prostate has limited additional benefit over background cores for larger MRI-identified tumors.


Loading...
Thumbnail Image

Type

Article

Change log

Authors

Patterson, Andrew J 
Koo, Brendan C 
Wadhwa, Karan 
Warren, Anne Y 

Abstract

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: Seventy-six 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, and 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 cutoff value of 1.0 cm in short axis was applied, resulting in a sensitivity of 83.3 % and a 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 >1.0 cm.

Description

Keywords

Image-guided biopsy, Magnetic resonance imaging, Prostate cancer, Transperineal, Ultrasound, Aged, Follow-Up Studies, Humans, Image-Guided Biopsy, Magnetic Resonance Imaging, Interventional, Male, Middle Aged, Neoplasm Grading, Perineum, Prostate, Prostatic Neoplasms, Reproducibility of Results, Retrospective Studies, Ultrasonography, Interventional

Journal Title

World J Urol

Conference Name

Journal ISSN

0724-4983
1433-8726

Volume Title

Publisher

Springer Science and Business Media LLC
Sponsorship
Cancer Research Uk (None)
Prostate Cancer UK (PA14-012)
Cancer Research Uk (None)
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.