Mp16-02 Role of Simultaneous Trus Guided Random Biopsy in Men With Unilateral Cancer Suspicious Regions Undergoing Mri-us Fusion Targeted Prostate Biopsy
Year: 2016
Type: article
Abstract: You have accessJournal of UrologyProstate Cancer: Detection & Screening I1 Apr 2016MP16-02 ROLE OF SIMULTANEOUS TRUS GUIDED RANDOM BIOPSY IN MEN WITH UNILATERAL CANCER SUSPICIOUS REGIONS UNDERGOING MRI-US FUSION TARGETED PROSTATE BIOPSY Darren J Bryk, Elton Llukani, Andrew B Rosenkrantz, Samir S Taneja, William C Huang, and Herbert Lepor Darren J BrykDarren J Bryk More articles by this author , Elton LlukaniElton Llukani More articles by this author , Andrew B RosenkrantzAndrew B Rosenkrantz More articles by this author , Samir S TanejaSamir S Taneja More articles by this author , William C HuangWilliam C Huang More articles by this author , and Herbert LeporHerbert Lepor More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.2567AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES MRI-US fusion targeted prostate biopsy (MRIUSbx) alone increases detection of significant prostate cancer (PCa) and decreases detection of insignificant PCa compared to 12 core TRUS guided random biopsy (TRUSbx) (Mendhiratta et al, J Urol. 2015;194:1601). The role of TRUSbx at the time of MRIUSbx remains controversial. METHODS From March 2012 to May 2015, 153 men with a single unilateral multiparametric MRI (mpMRI) cancer suspicious region (CSR) underwent TRUSbx with a 12 core computer generated template and MRIUSbx using the Profuse software and ei-Nav|Artemis system. Four cores were targeted into each CSR. The lengths of all Gleason patterns (GP) were ascertained. Suspicion scores (ss) were assigned using a Likert scale between 2-5 (Rosenkrantz et al, Radiology. 2013;269(2):482). RESULTS PCa was found in 67 of the 153 men (43.8%). Cancer detection rates (CDR) are shown according to ss (Table). Of the twenty two (14.4%) TRUSbx contralateral to the CSR (CTRUSbx) with PCa, only 4 (2.6%) exhibited GP 4 (Table). The negative predictive value (NPV) of mpMRI contralateral to the CSR for any cancer or for any GP 4 was 85.6% and 97.4%, respectively. Of the CTRUSbx with GP 4, the mean (range) GP 4 length was 0.53 mm (0.2-1.2 mm). The significance of this extremely low volume of GP 4 is case dependent. There were no CTRUSbx with Gleason 8. Only 2 (1.3%) of the CTRUSbx were the exclusive site of GP 4 and had GP 4 lengths of 0.2 mm and 1.2 mm. The addition of the ipsilateral TRUSbx to the MRIUSbx significantly increased the CDRs of any cancer (p<0.0001) and of GP4 disease (p=0.016). CONCLUSIONS TRUSBx ipsilateral to the CSR should be combined with MRIUSBx since it increases the CDR of GP 4 possibly by compensating for the inherent sampling limitations of co-registration technology. TRUSBx contralateral to the MRIUSBx should be discouraged since it rarely increases the CDR of GP 4. The present study confirms the extremely high NPV of mpMRI for significant disease. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e160-e161 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Darren J Bryk More articles by this author Elton Llukani More articles by this author Andrew B Rosenkrantz More articles by this author Samir S Taneja More articles by this author William C Huang More articles by this author Herbert Lepor More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
Source: The Journal of Urology
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2330936737