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2050 CONTEMPORARY IMAGE-GUIDED TARGETED PROSTATE BIOPSY BETTER CHARACTERIZES CANCER VOLUME, GLEASON GRADE AND ITS 3D LOCATION COMPARED TO SYSTEMATIC BIOPSY

2012; Lippincott Williams & Wilkins; Volume: 187; Issue: 4S Linguagem: Inglês

10.1016/j.juro.2012.02.2215

1527-3792

Scott Leslie, Alvin C. Goh, Pierre-Marie Lewandowski, Eric Yi‐Hsiu Huang, Andre Luis Abreu, André Berger, Hamed Ahmadi, Isuru Jayaratna, Sunao Shoji, Inderbir S. Gill, Osamu Ukimura,

Cancer, Lipids, and Metabolism

You have accessJournal of UrologyProstate Cancer: Detection and Screening IV1 Apr 20122050 CONTEMPORARY IMAGE-GUIDED TARGETED PROSTATE BIOPSY BETTER CHARACTERIZES CANCER VOLUME, GLEASON GRADE AND ITS 3D LOCATION COMPARED TO SYSTEMATIC BIOPSY Scott Leslie, Alvin Goh, Pierre-Marie Lewandowski, Eric Yi-Hsiu Huang, Andre Luis de Castro Abreu, Andre K. Berger, Hamed Ahmadi, Isuru Jayaratna, Sunao Shoji, Inderbir S. Gill, and Osamu Ukimura Scott LeslieScott Leslie Los Angeles, CA More articles by this author , Alvin GohAlvin Goh Los Angeles, CA More articles by this author , Pierre-Marie LewandowskiPierre-Marie Lewandowski Los Angeles, CA More articles by this author , Eric Yi-Hsiu HuangEric Yi-Hsiu Huang Los Angeles, CA More articles by this author , Andre Luis de Castro AbreuAndre Luis de Castro Abreu Los Angeles, CA More articles by this author , Andre K. BergerAndre K. Berger Los Angeles, CA More articles by this author , Hamed AhmadiHamed Ahmadi Los Angeles, CA More articles by this author , Isuru JayaratnaIsuru Jayaratna Los Angeles, CA More articles by this author , Sunao ShojiSunao Shoji Los Angeles, CA More articles by this author , Inderbir S. GillInderbir S. Gill Los Angeles, CA More articles by this author , and Osamu UkimuraOsamu Ukimura Los Angeles, CA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.2215AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Contemporary trans rectal ultrasound (TRUS) prostate biopsy can be guided by high-resolution ultrasound, magnetic resonance imaging (MRI) or MR/US fusion. The aim of this study is to compare the characteristics of the biopsy-proven cancer between image-guided targeted biopsy and systematic biopsy. METHODS Between January 2010 and September 2011, 127 consecutive patients underwent outpatient TRUS biopsy using the real-time 3D TRUS-tracking system (Urostation®, Koelis, France), which enabled US-guided and/or MR/US fusion targeted biopsies. In patients who had previous negative biopsies or who were under active surveillance, multi-parametric prostate MRI (n=48) was performed prior to TRUS biopsy. If MRI suggested a focal lesion, 3D volume data of the MRI was elastically fused with TRUS at the time of biopsy. The MRI was abnormal in 29 of the 48 patients (60%), and they subsequently underwent MRI/US fusion. Overall 1500 systematic biopsies (SB), 259 ultrasound guided targeted biopsies (US-TB) and 79 MRI fusion targeted biopsies (MR-TB), were performed. The mean number of SB, US-TB and MR-TB cores per patient was 11.9, 2.6 and 2.7 respectively. RESULTS Of the 127 patients the mean age was 65.4, mean PSA was 8.8, and mean prostate volume was 50.8ml. 60 of the 127 patients had a positive biopsy (47%). The table demonstrates there is an increased likelihood of identifying significant cancer with the targeted biopsies when compared to the systematic biopsies. Gleason 7 or higher cancer was identified in 60% and 54% of patients with US-TB and MR-TB, compared to 40% for SB (p=0.014). Similarly for percent core involved, the targeted biopsies more commonly identified cancer in greater than 50% of the core compared to SB (p=0.026). SB US-TBSB MR-TBSB p-valueSB Positive rate per core 131/1500(8.7%) 100/259(38.6%) 32/79(40.5%) 0.0001 Positive rate per patient 50/126(39.7%) 45/101(44.6%) 13/29(44.8%) 0.724 Gleason 6/7/8/9/10 30/10/3/6/1 18/15/3/9/0 6/4/1/2/0 Gleason ≥7 20/50(40%) 27/45(60%) 7/13(54%) 0.014 Mean% core positive (SD) 26.4%(22.5) 40.6%(28.7) 47.3%(28.6) >50% core involved 8/50(16%) 16/45(36%) 6/13(46%) 0.026 In all cases the spatial location of each biopsy was documented using 3D TRUS-tracking, allowing more accurate localization of the cancer within the prostate. This information is useful for any future intervention such as repeat biopsies or focal therapy. CONCLUSIONS Contemporary image-guided targeted prostate biopsy identifies greater core involvement and higher Gleason grade compared to systematic image-blind biopsies. Targeted biopsies using 3D mapping techniques significantly alter management decisions in patients with prostate cancer. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e827 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Scott Leslie Los Angeles, CA More articles by this author Alvin Goh Los Angeles, CA More articles by this author Pierre-Marie Lewandowski Los Angeles, CA More articles by this author Eric Yi-Hsiu Huang Los Angeles, CA More articles by this author Andre Luis de Castro Abreu Los Angeles, CA More articles by this author Andre K. Berger Los Angeles, CA More articles by this author Hamed Ahmadi Los Angeles, CA More articles by this author Isuru Jayaratna Los Angeles, CA More articles by this author Sunao Shoji Los Angeles, CA More articles by this author Inderbir S. Gill Los Angeles, CA More articles by this author Osamu Ukimura Los Angeles, CA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...