Systematic versus Targeted Magnetic Resonance Imaging/Ultrasound Fusion Prostate Biopsy among Men with Visible Lesions
2021; Lippincott Williams & Wilkins; Volume: 207; Issue: 1 Linguagem: Inglês
10.1097/ju.0000000000002120
ISSN1527-3792
AutoresHiten D. Patel, Elizabeth L. Koehne, Steven M. Shea, Andrew M. Fang, Alex Gorbonos, Marcus L. Quek, Robert C. Flanigan, Ari Goldberg, Soroush Rais–Bahrami, Gopal N. Gupta,
Tópico(s)Urologic and reproductive health conditions
ResumoNo AccessJournal of UrologyAdult Urology1 Jan 2022Systematic versus Targeted Magnetic Resonance Imaging/Ultrasound Fusion Prostate Biopsy among Men with Visible LesionsThis article is commented on by the following:Editorial Comment Hiten D. Patel, Elizabeth L. Koehne, Steven M. Shea, Andrew M. Fang, Alex Gorbonos, Marcus L. Quek, Robert C. Flanigan, Ari Goldberg, Soroush Rais-Bahrami, and Gopal N. Gupta Hiten D. PatelHiten D. Patel *Correspondence: Department of Urology, Loyola University Medical Center, 2160 S 1st Ave., Bldg. 54, Rm. 240, Maywood, Illinois 60153 telephone: 618-534-4942; FAX: 203-902-3847; E-mail Address: [email protected] http://orcid.org/0000-0003-4028-010X Department of Urology, Loyola University Medical Center, Maywood, Illinois , Elizabeth L. KoehneElizabeth L. Koehne Department of Urology, Loyola University Medical Center, Maywood, Illinois , Steven M. SheaSteven M. Shea Department of Radiology, Loyola University Medical Center, Maywood, Illinois , Andrew M. FangAndrew M. Fang Department of Urology, University of Alabama at Birmingham, Birmingham, Alabama , Alex GorbonosAlex Gorbonos Department of Urology, Loyola University Medical Center, Maywood, Illinois , Marcus L. QuekMarcus L. Quek Department of Urology, Loyola University Medical Center, Maywood, Illinois , Robert C. FlaniganRobert C. Flanigan Department of Urology, Loyola University Medical Center, Maywood, Illinois , Ari GoldbergAri Goldberg Department of Radiology, Loyola University Medical Center, Maywood, Illinois , Soroush Rais-BahramiSoroush Rais-Bahrami Department of Urology, University of Alabama at Birmingham, Birmingham, Alabama Department of Radiology, University of Alabama at Birmingham, Birmingham, Alabama O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, Alabama , and Gopal N. GuptaGopal N. Gupta Department of Urology, Loyola University Medical Center, Maywood, Illinois Department of Radiology, Loyola University Medical Center, Maywood, Illinois Department of Surgery, Loyola University Medical Center, Maywood, Illinois View All Author Informationhttps://doi.org/10.1097/JU.0000000000002120AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Multiparametric magnetic resonance imaging (mpMRI)-ultrasound (US) fusion-guided biopsy may improve prostate cancer (PCa) detection and reduce grade misclassification. We compared PCa detection rates on systematic, magnetic resonance imaging-targeted, and combined biopsy with evaluation of important subgroups. Materials and Methods: Men with clinical suspicion of harboring PCa from 2 institutions with visible Prostate Imaging–Reporting and Data System (PI-RADSTMv2) lesions receiving mpMRI-US fusion-guided prostate biopsy were included (2015–2020). Detection of PCa was categorized by grade group (GG). Clinically-significant PCa (csPCa) was defined as ≥GG2. Patients were stratified by biopsy setting and PI-RADS. Results: Of 1,236 patients (647 biopsy-naïve) included, 626 (50.6%) harbored PCa and 412 (33.3%) had csPCa on combined biopsy. Detection of csPCa was 27.9% vs 23.3% (+4.6%) and GG1 PCa was 11.3% vs 17.8% (−6.5%) for targeted vs systematic cores. Benefit in csPCa detection was higher in the prior negative than biopsy-naïve setting (+7.8% [p <0.0001] vs +1.7% [p=0.3]) while reduction in GG1 PCa detection remained similar (−5.6% [p=0.0002] vs −7.3% [p=0.0001]). Targeted biopsy showed increased csPCa detection for PI-RADS 5, decrease in GG1 for PI-RADS 3, and both for PI-RADS 4 relative to systematic biopsy. Combined biopsy detected more csPCa (+10.0%) and slightly fewer GG1 PCa (−0.5%) compared to systematic alone. Upgrading to ≥GG2 by targeted biopsy occurred in 9.8% with no cancer and 23.6% with GG1 on systematic biopsy. Conclusions: Combined biopsy doubled the benefit of targeted biopsy alone in detection of csPCa without increasing GG1 PCa diagnoses relative to systematic biopsy. Utility of targeted biopsy was higher in the prior negative biopsy cohort, but advantages of combined biopsy were maintained regardless of biopsy history. References 1. : Downgrading of grade group 2 intermediate-risk prostate cancer from biopsy to radical prostatectomy: comparison of outcomes and predictors to identify potential candidates for active surveillance. Cancer 2020; 126: 1632. Google Scholar 2. : Comparison of MR/ultrasound fusion-guided biopsy with ultrasound-guided biopsy for the diagnosis of prostate cancer. JAMA 2015; 313: 390. Google Scholar 3. : Diagnostic accuracy of multi-parametric MRI and TRUS biopsy in prostate cancer (PROMIS): a paired validating confirmatory study. Lancet 2017; 389: 815. Google Scholar 4. : MRI-targeted or standard biopsy for prostate-cancer diagnosis. N Engl J Med 2018; 378: 1767. Google Scholar 5. : Comparison of multiparametric magnetic resonance imaging-targeted biopsy with systematic transrectal ultrasonography biopsy for biopsy-naive men at risk for prostate cancer: a phase 3 randomized clinical trial. JAMA Oncol 2021; 7: 534. Google Scholar 6. : Use of prostate systematic and targeted biopsy on the basis of multiparametric MRI in biopsy-naive patients (MRI-FIRST): a prospective, multicentre, paired diagnostic study. Lancet Oncol 2019; 20: 100. Google Scholar 7. : Comparison of targeted vs systematic prostate biopsy in men who are biopsy naive: the prospective assessment of image registration in the diagnosis of prostate cancer (PAIREDCAP) study. JAMA Surg 2019; 154: 811. Google Scholar 8. : MRI-targeted, systematic, and combined biopsy for prostate cancer diagnosis. N Engl J Med 2020; 382: 917. Google Scholar 9. : Comparison of magnetic resonance imaging and ultrasound (MRI-US) fusion-guided prostate biopsies obtained from axial and sagittal approaches. BJU Int 2015; 115: 772. Google Scholar 10. : The REDCap consortium: building an international community of software platform partners. J Biomed Inform 2019; 95: 103208. Google Scholar 11. : Improving prostate cancer screening and diagnosis: health policy and biomarkers beyond PSA. JAMA Oncol 2016; 2: 867. Google Scholar 12. : Imaging as a personalized biomarker for prostate cancer risk stratification. Diagnostics (Basel) 2018; 8: 80. Google Scholar 13. : Randomized study of systematic biopsy versus magnetic resonance imaging and targeted and systematic biopsy in men on active surveillance (ASIST): 2-year postbiopsy follow-up. Eur Urol 2020; 77: 311. Google Scholar 14. : The magnetic resonance imaging in active surveillance (MRIAS) trial: use of baseline multiparametric magnetic resonance imaging and saturation biopsy to reduce the frequency of surveillance prostate biopsies. J Urol 2020; 203: 910. Link, Google Scholar 15. : Variability of the positive predictive value of PI-RADS for prostate MRI across 26 centers: experience of the society of abdominal radiology prostate cancer disease-focused panel. Radiology 2020; 296: 76. Google Scholar 16. : Prostate cancer management choices in patients undergoing multiparametric magnetic resonance imaging/ultrasound fusion biopsy compared to systematic biopsy. Urol Oncol 2018; 36: 241.e7. Google Scholar 17. : Advances in the selection of patients with prostate cancer for active surveillance. Nat Rev Urol 2021; 18: 197. Google Scholar 18. : Risk of prostate cancer for men with prior negative biopsies undergoing magnetic resonance imaging compared with biopsy-naive men: a prospective evaluation of the PLUM cohort. Cancer 2021; https://doi:10.1002/cncr.33875. Google Scholar 19. : Net benefit approaches to the evaluation of prediction models, molecular markers, and diagnostic tests. BMJ 2016: 352: i6. Google Scholar Financial Disclosures/Funding Source: Efforts to support data extraction and maintenance of The Prospective Loyola University mpMRI Prostate Biopsy Cohort database is supported by funding from Siemens Medical Solutions USA, Inc. This work was funded in part by Junior Faculty Development Grant (ACS-IRG 001-53) and by Developmental funds from the UAB Comprehensive Cancer Center Support Grant (NCI P30 CA 013148) granted to Soroush Rais-Bahrami. © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsRelated articlesJournal of UrologyOct 4, 2021, 12:00:00 AMEditorial Comment Volume 207Issue 1January 2022Page: 108-117Supplementary Materials Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.Keywordsdiagnostic techniques, urologicalbiopsymagnetic resonance imagingprostatic neoplasmsAcknowledgmentsWe would like to acknowledge the time and effort of all staff who have helped create and maintain the Prospective Loyola University mpMRI Prostate Biopsy Cohort and the University of Alabama Prostate Biopsy Cohort.MetricsAuthor Information Hiten D. Patel Department of Urology, Loyola University Medical Center, Maywood, Illinois *Correspondence: Department of Urology, Loyola University Medical Center, 2160 S 1st Ave., Bldg. 54, Rm. 240, Maywood, Illinois 60153 telephone: 618-534-4942; FAX: 203-902-3847; E-mail Address: [email protected] More articles by this author Elizabeth L. Koehne Department of Urology, Loyola University Medical Center, Maywood, Illinois More articles by this author Steven M. Shea Department of Radiology, Loyola University Medical Center, Maywood, Illinois More articles by this author Andrew M. Fang Department of Urology, University of Alabama at Birmingham, Birmingham, Alabama More articles by this author Alex Gorbonos Department of Urology, Loyola University Medical Center, Maywood, Illinois More articles by this author Marcus L. Quek Department of Urology, Loyola University Medical Center, Maywood, Illinois More articles by this author Robert C. Flanigan Department of Urology, Loyola University Medical Center, Maywood, Illinois More articles by this author Ari Goldberg Department of Radiology, Loyola University Medical Center, Maywood, Illinois More articles by this author Soroush Rais-Bahrami Department of Urology, University of Alabama at Birmingham, Birmingham, Alabama Department of Radiology, University of Alabama at Birmingham, Birmingham, Alabama O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, Alabama Equal study contribution as senior author. More articles by this author Gopal N. Gupta Department of Urology, Loyola University Medical Center, Maywood, Illinois Department of Radiology, Loyola University Medical Center, Maywood, Illinois Department of Surgery, Loyola University Medical Center, Maywood, Illinois Equal study contribution as senior author. More articles by this author Expand All Financial Disclosures/Funding Source: Efforts to support data extraction and maintenance of The Prospective Loyola University mpMRI Prostate Biopsy Cohort database is supported by funding from Siemens Medical Solutions USA, Inc. This work was funded in part by Junior Faculty Development Grant (ACS-IRG 001-53) and by Developmental funds from the UAB Comprehensive Cancer Center Support Grant (NCI P30 CA 013148) granted to Soroush Rais-Bahrami. Advertisement PDF DownloadLoading ...
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