Assessment of the Performance of Magnetic Resonance ImagingUltrasound Fusion Guided Prostate Biopsy against a Combined Targeted Plus Systematic Biopsy Approach Using 24-Core Transperineal Template Saturation Mapping Prostate Biopsy

Abstract EN

Objective.

To compare the performance of multiparametric resonance imaging/ultrasound fusion targeted biopsy (MRI/US-TBx) to a combined biopsy strategy (MRI/US-TBx plus 24-core transperineal template saturation mapping biopsy (TTMB)).

Methods.

Between May 2012 and October 2015, all patients undergoing MRI/US-TBx at our institution were included for analysis.

Patients underwent MRI/US-TBx of suspicious lesions detected on multiparametric MRI + / - simultaneous TTMB.

Subgroup analysis was performed on patients undergoing simultaneous MRI/US-TBx + TTMB.

Primary outcome was PCa detection.

Significant PCa was defined as ≥Gleason score (GS) 3 + 4 = 7 PCa.

McNemar’s test was used to compare detection rates between MRI/US-TBx and the combined biopsy strategy.

Results.

148 patients underwent MRI/US-TBx and 80 patients underwent MRI/US-TBx + TTMB.

In the MRI/US-TBx versus combined biopsy strategy subgroup analysis ( n = 80 ), there were 55 PCa and 38 significant PCa.

The detection rate for the combined biopsy strategy versus MRI/US-TBx for significant PCa was 49% versus 40% ( p = 0.02 ) and for insignificant PCa was 20% versus 10% ( p = 0.04 ), respectively.

Eleven cases (14%) of significant PCa were detected exclusively on MRI/US-TBx and 7 cases (8.7%) of significant PCa were detected exclusively on TTMB.

Conclusions.

A combined biopsy approach (MRI/US-TBx + TTMB) detects more significant PCa than MRI/US-TBx alone; however, it will double the detection rate of insignificant PCa.