scholarly journals Does Adding Standard Systematic Biopsy to Targeted Prostate Biopsy in PI-RADS 3 to 5 Lesions Enhance the Detection of Clinically Significant Prostate Cancer? Should All Patients with PI-RADS 3 Undergo Targeted Biopsy?

Diagnostics ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 1335
Author(s):  
Enrique Gomez-Gomez ◽  
Sara Moreno Sorribas ◽  
Jose Valero-Rosa ◽  
Ana Blanca ◽  
Juan Mesa ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Magnetic Resonance ◽  
Detection Rate ◽  
Magnetic Resonance Images ◽  
Targeted Biopsy ◽  
Resonance Imaging ◽  
Negative Biopsy ◽  
The Mean ◽  
Clinically Significant ◽  
Systematic Biopsy

Introduction. Our aim was to assess the value of adding standard biopsy to targeted biopsy in cases of suspicious multiparametric magnetic resonance imaging (mp-MRI) and also to evaluate when a biopsy of a PI-RADS 3 lesion could be avoided. Methods: A retrospective study of patients who underwent targeted biopsy plus standard systematic biopsy between 2016–2019 was performed. All the 1.5 T magnetic resonance images were evaluated according to PI-RADSv.2. An analysis focusing on the clinical scenario, lesion location, and PI-RADS score was performed. Results. A total of 483 biopsies were evaluated. The mean age was 65 years, with a PSA density of 0.12 ng/mL/cc. One-hundred and two mp-MRIs were categorized as PI-RADS-3. Standard biopsy was most helpful in detecting clinically significant prostate cancer (csPCa) in patients in the active surveillance (AS) cohort (increasing the detection rate 12.2%), and in peripheral lesions (6.5%). Adding standard biopsy showed no increase in the detection rate for csPCa in patients with PI-RADS-5 lesions. Considering targeted biopsy in patients with PI-RADS 3 lesions, a higher detection rate was shown in biopsy-naïve patients versus AS and in patients with a previous negative biopsy (p = 0.002). Furthermore, in these patients, the highest rate of csPCa detection was in anterior lesions [42.9% (p = 0.067)]. Conclusions. Our results suggest that standard biopsy could be safely omitted in patients with anterior lesions and in those with PI-RADS-5 lesions. Targeted biopsy for PI-RADS-3 lesions would be less effective in peripheral lesions with a previous negative biopsy.

scholarly journals Magnetic resonance/ultrasound fusion targeted biopsy of the prostate can be improved by adding systematic biopsy

2021 ◽  
Author(s):  
Victor Mihail Cauni ◽  
Dan Stanescu ◽  
Florin Tanase ◽  
Bogdan Mihai ◽  
Cristian Persu
Keyword(s):  
Prostate Cancer ◽  
Magnetic Resonance ◽  
Cancer Detection ◽  
Detection Rate ◽  
Specific Antigen ◽  
Cancer Detection Rate ◽  
Targeted Biopsy ◽  
Detection Rates ◽  
Clinically Significant ◽  
Systematic Biopsy

Aim: Magnetic resonance/ ultrasound fusion targeted biopsy (Tbs) is widely used for diagnosing prostate cancer (PCa). The aim of our study was to compare the cancer detection rate (CDR) and the clinically significant prostate cancer detection rate (csPCa) of the magnetic resonance/ultrasound fusion targeted biopsy with those of the standard systematic biopsy (Sbs) and of the combination of both techniques.Material and methods: A total of 182 patients underwent magnetic resonance/ultrasound fusion Tbs on the prostate for PCa suspicion based on multiparametric magnetic resonance imaging (mMRI) detection of lesions with PI-RADSv2 score ≥3. A total of 78 patients had prior negative biopsies. Tb was performed by taking 2-4 cores from each suspected lesion, followed by Sb with 12 cores. We evaluated the overall detection rate of PCa and clinically significant prostate cancer, defined as any PCa with Gleason score ≥3+4.Results: Median prostate specific antigen (PSA) level pre-biopsy was 7.4 ng/ml and median free-PSA/PSA ratio was 10.2%. Patient median age was 62 years old. PIRADSv2 score was 3 in 54 cases, 4 in 96 cases and 5 in 32 cases. PI-RADS-dependent detection rate of Tbs for scores 3, 4 and 5 was 25.9%, 65.6% and 84.4%, respectively, with csPCa detection rates of 24.1%, 54.2%, and 71.9%. Overall detection rate was 57.1% for Tbs, which increased to 60.4% by adding Sbs results. Detection rate for clinically significant prostate cancer (csPCa) was 48.4% and increased to 51.1% by adding Sbs. Overall detection rate for repeated biopsy was 50% and 68.3% for biopsy in naïve patients. Sbs detection rate was 55.5%, 8 patients having a negative biopsy on Tbs.Conclusions: When Tbs is considered due to a PI-RADS ≥3 lesion on mMRI, combined Tbs + Sbs increases the overall CDR and csPCa detection rates.

scholarly journals Transrectal ultrasound-guided biopsy for prostate cancer detection: Systematic and/or magnetic-resonance imaging-targeted

2017 ◽  
Vol 11 (9) ◽  
pp. E330-7 ◽  
Author(s):  
Franck Bladou ◽  
Cora Fogaing ◽  
Mark Levental ◽  
Samuel Aronson ◽  
Mona Alameldin ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Prostate Cancer ◽  
Magnetic Resonance ◽  
Cancer Detection ◽  
Prostate Biopsy ◽  
Detection Rate ◽  
Specific Antigen ◽  
Resonance Imaging ◽  
Negative Biopsy ◽  
Clinically Significant

Introduction: Magnetic resonance imaging (MRI) is being more widely used in the detection of prostate cancer (PCa), particularly after an initial negative biopsy. In this study, we compared 12-core systematic biopsy (SYS), MRI-targeted biopsy (TAR), and the association of systematic and MRI-targeted (SYS+TAR) prostate biopsy in patients with previous biopsy and those who were biopsy-naive to evaluate the differences in terms of cancer detection and clinically significant cancer detection between the three modalities.Methods: Overall, 203 consecutive patients with suspicion of PCa were analyzed; 48.2% were biopsy-naive and 51.7% had at least one previous negative prostate biopsy. The median age was 66 years, median prostate-specific antigen (PSA) level was 7.9 ng/mL and median prostate volume was 46 mL. 38.9% had SYS, 19.2% TAR only, and 41.8% had SYS+TAR biopsy.Results: Overall, the PCa detection (PCaDR) was 63%. The SYS+TAR biopsy detected significantly more cancer than SYS and TAR only biopsies (72.9% vs. 56.9% and 53.8% respectively; p=0.03). Detection rate of clinically significant cancer (csPCaDR) was 50.7% overall; 65.8% in the SYS+TAR biopsy vs. 39.2% in the SYS and 48.7% in the TAR groups (p=0.002). In the biopsy-naive group, PCaDR and csPCaDR were significantly higher in the SYS+TAR group than in the SYS and TAR groups (p=0.01). In the repeat biopsy group, PCaDR and csPCaDR were equivalent in the TAR and SYS+TAR groups and higher than in the SYS group (p=0.001).Conclusions: TAR biopsy, when added to SYS biopsy, was associated with a higher detection rate of csPCa in biopsy-naive patients when compared to TAR and SYS only biopsies. In patients after previous negative biopsy, detection rates of csPCa were equivalent for SYS+TAR and TAR only biopsies, but higher than SYS.

Naive patients with suspicious prostate cancer and positive multiparametric magnetic resonance imaging (mp-MRI): is it time for fusion target biopsy alone?

2021 ◽  
pp. 205141582110237
Author(s):  
Enrico Checcucci ◽  
Sabrina De Cillis ◽  
Daniele Amparore ◽  
Diletta Garrou ◽  
Roberta Aimar ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Prostate Cancer ◽  
Magnetic Resonance ◽  
Detection Rate ◽  
Resonance Imaging ◽  
Fusion Biopsy ◽  
Grade Group ◽  
Final Pathology ◽  
Multiparametric Magnetic Resonance Imaging ◽  
Clinically Significant

Objectives: To determine if standard biopsy still has a role in the detection of prostate cancer or clinically significant prostate cancer in biopsy-naive patients with positive multiparametric magnetic resonance imaging. Materials and methods: We extracted, from our prospective maintained fusion biopsy database, patients from March 2014 to December 2018. The detection rate of prostate cancer and clinically significant prostate cancer and complication rate were analysed in a cohort of patients who underwent fusion biopsy alone (group A) or fusion biopsy plus standard biopsy (group B). The International Society of Urological Pathology grade group determined on prostate biopsy with the grade group determined on final pathology among patients who underwent radical prostatectomy were compared. Results: Prostate cancer was found in 249/389 (64.01%) and 215/337 (63.8%) patients in groups A and B, respectively ( P=0.98), while the clinically significant prostate cancer detection rate was 57.8% and 55.1% ( P=0.52). No significant differences in complications were found. No differences in the upgrading rate between biopsy and final pathology finding after radical prostatectomy were recorded. Conclusions: In biopsy-naive patients, with suspected prostate cancer and positive multiparametric magnetic resonance imaging the addition of standard biopsy to fusion biopsy did not increase significantly the detection rate of prostate cancer or clinically significant prostate cancer. Moreover, the rate of upgrading of the cancer grade group between biopsy and final pathology was not affected by the addition of standard biopsy. Level of evidence: Not applicable for this multicentre audit.

scholarly journals Magnetic Resonance Imaging-targeted Biopsy Versus Systematic Biopsy in the Detection of Prostate Cancer: A Systematic Review and Meta-analysis

2019 ◽  
Vol 76 (3) ◽  
pp. 284-303 ◽  
Author(s):  
Veeru Kasivisvanathan ◽  
Armando Stabile ◽  
Joana B. Neves ◽  
Francesco Giganti ◽  
Massimo Valerio ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Prostate Cancer ◽  
Systematic Review ◽  
Magnetic Resonance ◽  
Meta Analysis ◽  
Targeted Biopsy ◽  
Resonance Imaging ◽  
Systematic Biopsy

scholarly journals Evidence-based guideline recommendations on multiparametric magnetic resonance imaging in the diagnosis of prostate cancer: A Cancer Care Ontario clinical practice guideline

2017 ◽  
Vol 11 (1-2) ◽  
pp. 1 ◽  
Author(s):  
Masoom A. Haider ◽  
Xiaomei Yao ◽  
Andrew Loblaw ◽  
Antonio Finelli
Keyword(s):  
Magnetic Resonance Imaging ◽  
Prostate Cancer ◽  
Magnetic Resonance ◽  
Practice Guideline ◽  
Elevated Risk ◽  
Cochrane Library ◽  
Targeted Biopsy ◽  
Resonance Imaging ◽  
Multiparametric Magnetic Resonance Imaging ◽  
Systematic Biopsy

This clinical guideline focuses on: 1) the use of multiparametric magnetic resonance imaging (mpMRI) in diagnosing clinically significant prostate cancer (CSPC) in patients with an elevated risk of CSPC and who are biopsy-naïve; and 2) the use of mpMRI in diagnosing CSPC in patients with a persistently elevated risk of having CSPC and who have a negative transrectal ultrasound (TRUS)-guided systematic biopsy.The methods of the Practice Guideline Development Cycle were used. MEDLINE, EMBASE, the Cochrane Library (1997‒April 2014), main guideline websites, and relevant annual meeting abstracts (2011‒2014) were searched. Internal and external reviews were conducted.The two main recommendations are:Recommendation 1: In patients with an elevated risk of CSPC (according to prostate-specific antigen [PSA] levels and/or nomograms) who are biopsy-naïve: mpMRI followed by targeted biopsy (biopsy directed at cancer-suspicious foci detected with mpMRI) should not be considered the standard of care; data from future research studies are essential and should receive high-impact trial funding to determine the value of mpMRI in this clinical context.Recommendation 2:In patients who had a prior negative TRUS-guided systematic biopsy and demonstrate an increasing risk of having CSPC since prior biopsy (e.g., continued rise in PSA and/or change in findings from digital rectal examination): mpMRI followed by targeted biopsy may be considered to help in detecting more CSPC patients compared with repeated TRUS-guided systematic biopsy.

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