Pd47-09 Optimizing Use of Mri-us Fusion Targeted Biopsy: Updated Experience in 1639 Combined Systematic and Targeted Prostate Biopsies
Year: 2018
Type: article
Study design: Observational Study
Abstract: You have accessJournal of UrologyProstate Cancer: Staging II1 Apr 2018PD47-09 OPTIMIZING USE OF MRI-US FUSION TARGETED BIOPSY: UPDATED EXPERIENCE IN 1639 COMBINED SYSTEMATIC AND TARGETED PROSTATE BIOPSIES Xiaosong Meng, Andrew B. Rosenkrantz, Richard Huang, Fang-Ming Deng, James S. Wysock, William C. Huang, Herbert Lepor, and Samir S. Taneja Xiaosong MengXiaosong Meng More articles by this author , Andrew B. RosenkrantzAndrew B. Rosenkrantz More articles by this author , Richard HuangRichard Huang More articles by this author , Fang-Ming DengFang-Ming Deng More articles by this author , James S. WysockJames S. Wysock More articles by this author , William C. HuangWilliam C. Huang More articles by this author , Herbert LeporHerbert Lepor More articles by this author , and Samir S. TanejaSamir S. Taneja More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.2169AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Adoption of prostate MRI and MRI-US fusion targeted biopsy (MRF-TB) has increased over the past few years. Although MRF-TB improves detection of clinically significant prostate cancer (csPCa) while limiting over-detection of indolent disease, it is not clear if both MRF-TB and systematic 12-core biopsy (SB) is necessary for all men. We hypothesized that MRF-TB might have the most benefit in men with high suspicion MRI regions of interest (ROI). In this study, we compare the relative cancer detection rates (CDR) of MRF-TB and SB for men presenting to our center for prostate biopsy (PBx). METHODS Between 6/12 and 10/17, a total of 2223 PBx was performed in 1960 men after pre-biopsy MRI and outcomes were recorded in an IRB-approved prospective database. Biopsy results, biopsy indications, and PI-RADS for ROI were queried from those who underwent both SB and MRF-TB using the Artemis/Pro-fuseTM (Eigen, Grass Valley) co-registration system. RESULTS 1639 PBx met inclusion criteria consisting of combined SB/MRF-TB, no prior treatment, no outside or 1.5T MRI, and available MRI suspicion score (mSS). MRF-TB detected fewer Gleason 6 (GS6) PCa [250(15%) vs 426(26%), p<0.001] and more GS ≥7 PCa [493(30%) vs 457(28%), p=0.021] as compared to SB in the cohort. When stratified by mSS, MRF-TB detected less GS6 PCa than SB for all mSS scores (Figure 1A). MRF-TB does not detect more GS ≥7 PCa for PI-RADS 2/3 ROI, but detects significantly more GS ≥7 PCa for mSS 4/5 ROI (Figure 1B). MRF-TB uniquely identified 27% (14), 19% (28), 30% (69) and 14% (22) compared to SB which uniquely identified 44% (23), 34% (50), 8% (19) and 3% (5) of all GS ≥7 PCa detected by combined SB/MRF-TB for mSS 2 (52), 3 (148), 4 (233) and 5 (157) ROI, respectively. CONCLUSIONS Overall, MRF-TB decreases over-detection of GS6 PCa as compared to SB, regardless of MRI suspicion score. MRF-TB is most useful in men with mSS 4/5 ROI as it significantly increases detection of GS ≥7 PCa compared to SB. Utilizing MRF-TB alone in men with mSS 2/3 ROI would avoid over-detection of GS6 PCa by 32%, but would miss 36.5% (73/200) of GS ≥7 PCa uniquely identified by SB, suggesting a continued need for combined SB/MRF-TB. Given that only 6% (24/390) of GS ≥7 PCa is uniquely identified by SB in men with mSS 4/5 ROI, MRF-TB alone may be sufficient. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e901 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Xiaosong Meng More articles by this author Andrew B. Rosenkrantz More articles by this author Richard Huang More articles by this author Fang-Ming Deng More articles by this author James S. Wysock More articles by this author William C. Huang More articles by this author Herbert Lepor More articles by this author Samir S. Taneja More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
Source: The Journal of Urology
Authors: Xiaosong Meng, Andrew B. Rosenkrantz, Richard Huang, Fang-Ming Deng, James S. Wysock, William C. Huang, Herbert Lepor, Samir S. Taneja
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2796190206