Are Magnetic Resonance Imaging-Transrectal Ultrasound Guided Targeted Biopsies Noninferior to Transrectal Ultrasound Guided Systematic Biopsies for the Detection of Prostate Cancer?
2016; Lippincott Williams & Wilkins; Volume: 196; Issue: 4 Linguagem: Inglês
10.1016/j.juro.2016.04.003
ISSN1527-3792
AutoresNicolas Barry Delongchamps, D. Portalez, É. Bruguière, Olivier Rouvière, Bernard Malavaud, Pierre Mozer, G. Fiard, F. Cornud,
Tópico(s)Radiomics and Machine Learning in Medical Imaging
ResumoNo AccessJournal of UrologyAdult Urology1 Oct 2016Are Magnetic Resonance Imaging-Transrectal Ultrasound Guided Targeted Biopsies Noninferior to Transrectal Ultrasound Guided Systematic Biopsies for the Detection of Prostate Cancer? Nicolas Barry Delongchamps, Daniel Portalez, Eric Bruguière, Olivier Rouvière, Bernard Malavaud, Pierre Mozer, Gaelle Fiard, François Cornud, and MURIELLE Study Group Nicolas Barry DelongchampsNicolas Barry Delongchamps Department of Urology, Cochin University Hospital, Paris Descartes University, Paris, France Inserm Unit U1151, Paris Descartes University, Paris, France , Daniel PortalezDaniel Portalez Rangueil University Hospital, Toulouse, France , Eric BruguièreEric Bruguière Clinique Pasteur, Toulouse, France , Olivier RouvièreOlivier Rouvière Hospices Civils de Lyon, Department of Urinary and Vascular Radiology, Edouard Herriot Hospital and University Lyon 1, Lyon, France , Bernard MalavaudBernard Malavaud Rangueil University Hospital, Toulouse, France , Pierre MozerPierre Mozer Hospices Civils de Lyon, Department of Urinary and Vascular Radiology, Edouard Herriot Hospital and University Lyon 1, Lyon, France , Gaelle FiardGaelle Fiard Grenoble University Hospital, Grenoble, France , François CornudFrançois Cornud Department of Urology, Cochin University Hospital, Paris Descartes University, Paris, France , and MURIELLE Study Group View All Author Informationhttps://doi.org/10.1016/j.juro.2016.04.003AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: In men with suspicion of prostate cancer the standard of cancer detection is transrectal ultrasound guided 10 to 12-core systematic biopsy. The targeted biopsy only strategy using magnetic resonance imaging-transrectal ultrasound image registration is gaining in popularity. We assessed the noninferiority of targeted vs systematic biopsy. Materials and Methods: Between June and October 2014 a total of 108 biopsy naïve patients with prostate specific antigen between 4 and 20 ng/ml, normal rectal examination and a single suspicious image on magnetic resonance imaging were included in study at 7 centers. Patients underwent systematic biopsy by a first operator blinded to magnetic resonance imaging, immediately followed by 3 targeted biopsies within the suspicious image by a second operator. The primary end point was the cancer detection rate. The noninferiority margin was set at −5%. The secondary end points were the detection rate of clinically significant prostate cancer (maximum cancer core length 5 mm or greater for Gleason 6 or any Gleason 7 or greater disease) and procedure duration. Results: Systematic and targeted biopsies detected cancer in 66 (61.1%) and 61 patients (56.5%), respectively. The mean difference was −4.5% with a 95% CI lower bound of −11.8%. A total of 13 patients with protocol violations were excluded from the per protocol analysis, which showed a mean difference of −5.2% with a 95% CI lower bound of −13.1%. Clinically significant prostate cancer was detected in 50 (46.2%) and 52 patients (48.1%) with systematic and targeted biopsies, respectively (p = 0.69). The mean ± SD duration of image fusion plus targeted biopsy was 16.7 ± 7 minutes vs 7.4 ± 3 for systematic biopsy (p <0.001). Conclusions: Targeted biopsy seemed to be inferior to systematic biopsy for overall cancer detection. Detection of clinically significant prostate cancer did not differ between targeted and systematic biopsies. References 1 : EAU guidelines on prostate cancer. Part II: treatment of advanced, relapsing, and castration-resistant prostate cancer. Eur Urol2014; 65: 467. 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Google Scholar © 2016 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byHanna N, Wszolek M, Mojtahed A, Nicaise E, Wu B, Gelpi-Hammerschmidt F, Salari K, Dahl D, Blute M, Harisinghani M and Feldman A (2019) Multiparametric Magnetic Resonance Imaging-Ultrasound Fusion Biopsy Improves but Does Not Replace Standard Template Biopsy for the Detection of Prostate CancerJournal of Urology, VOL. 202, NO. 5, (944-951), Online publication date: 1-Nov-2019.Truong M, Weinberg E, Hollenberg G, Borch M, Park J, Gantz J, Feng C, Frye T, Ghazi A, Wu G, Joseph J, Rashid H and Messing E (2016) Institutional Learning Curve Associated with Implementation of a Magnetic Resonance/Transrectal Ultrasound Fusion Biopsy Program Using PI-RADS™ Version 2: Factors that Influence SuccessUrology Practice, VOL. 5, NO. 1, (69-75), Online publication date: 1-Jan-2018.Smith J (2016) This Month in Adult UrologyJournal of Urology, VOL. 196, NO. 4, (973-974), Online publication date: 1-Oct-2016. Volume 196Issue 4October 2016Page: 1069-1075 Advertisement Copyright & Permissions© 2016 by American Urological Association Education and Research, Inc.Keywordsdiagnosisultrasonographymagnetic resonance imagingbiopsyprostatic neoplasmsAcknowledgmentsMURIELLE study group: Caroline Escourrou, Department of Urology, and Stéphanie Renault and Naïm Bouazza, Clinical Research Unit, Cochin University Hospital, Paris Descartes University, Jean-Michel Casanova, Clinique Saint Jean de Dieu, and Arachk de Gorski and Raphaelle Renard-Penna, Pitié Salpêtrière University Hospital, Pierre et Marie Curie University, Paris; Mathieu Roumiguié and Matthieu Thoulouzan, Rangueil University Hospital, Benoit Bordier, Vincent Misrai and Julien Guillotreau, Clinique Pasteur and Richard Aziza, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse; Jean-Luc Descotes and Noélie Hohn, Grenoble University Hospital, Grenoble; and Flavie Bratan, Fanny Cros and Thomas Sanzalone, Hospices Civils de Lyon, Department of Urinary and Vascular Radiology, Edouard Herriot Hospital and University Lyon 1, Lyon, France.MetricsAuthor Information Nicolas Barry Delongchamps Department of Urology, Cochin University Hospital, Paris Descartes University, Paris, France Inserm Unit U1151, Paris Descartes University, Paris, France Financial interest and/or other relationship with Koelis. More articles by this author Daniel Portalez Rangueil University Hospital, Toulouse, France More articles by this author Eric Bruguière Clinique Pasteur, Toulouse, France More articles by this author Olivier Rouvière Hospices Civils de Lyon, Department of Urinary and Vascular Radiology, Edouard Herriot Hospital and University Lyon 1, Lyon, France More articles by this author Bernard Malavaud Rangueil University Hospital, Toulouse, France More articles by this author Pierre Mozer Hospices Civils de Lyon, Department of Urinary and Vascular Radiology, Edouard Herriot Hospital and University Lyon 1, Lyon, France More articles by this author Gaelle Fiard Grenoble University Hospital, Grenoble, France More articles by this author François Cornud Department of Urology, Cochin University Hospital, Paris Descartes University, Paris, France Financial interest and/or other relationship with Koelis. More articles by this author MURIELLE Study Group More articles by this author Expand All Advertisement PDF downloadLoading ...
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