Targeted prostate biopsy in the diagnosis of prostate cancer: results from a prospective cohort study
Authors:   Spasokukotsky City Clinical Hospital, Moscow, Russia, Okishev Artem V. , Govorov Alexander V. ,   Yevdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia, Vasilyev Alexander O. ,   Yevdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia, Sadchenko Anton V. ,   Spasokukotsky City Clinical Hospital, Moscow, Russia, Kolontarev Konstantin B. ,   Yevdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia, Bormotin Alexey V. ,   Yevdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia, Kim Yuriy A. ,   Spasokukotsky City Clinical Hospital, Moscow, Russia, Kim Yuriy A. ,   Yevdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia, Kizun Boris A. ,   Yevdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia, Kizun Boris A. ,   Medical and Sanitary Unit of the Ministry of Internal Affairs of the Russian Federation for the City of Moscow, Moscow, Russia, Ramazanov Kerim K. ,   Spasokukotsky City Clinical Hospital, Moscow, Russia, Ramazanov Kerim K. ,   Yevdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia, Pushkar Dmitriy Y. ,   Yevdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia
Published: February 2021

Background. Detection of prostate cancer by various targeting methods of prostate biopsy is an important problem now. Aim. To improve the detection of prostate cancer (PCa), compare the methods of targeted biopsy – cognitive biopsy guided by MRI with biopsy guided by histos-canning, using a randomized biopsy of the prostate from twelve cores as a control method. Materials and methods. A total of 145 respondents who underwent a randomized biopsy of the prostate in combination with targeted techniques were divided into 3 samples in accordance with the methods of targeted biopsy. In the results, the detectability by targeted methods was compared with each other and with a randomized biopsy as a control method. The results were subjected to statistical processing in order to form the conclusions of the study. Results. The detection rate of prostate cancer in the cognitive biopsy group was 64.4%, in the histofusion group – 51.1%, in the cognitive biopsy with histofusion group – 69% (p<0.05). The detection of PCa when comparing positive targeted biopsies did not differ statistically significantly between the methods (38 and 36%, p=0.05). The percentage of positive biopsies was higher with histofusion biopsy (34.2%) than with cognitive biopsy (29.7%), the incidence of clinically sig-nificant cancer was higher according to the results of targeted methods compared with randomized biopsy (73% vs 37.5%, p<0.05). The highest complication rate with the combined use of the studied targeting techniques was 13.6%, while all complications belonged to the 1st category according to Clavien–Dindo. Conclusion. To optimize the diagnosis of prostate cancer, it is advisable to use a combination of targeted and “randomized” cores. The combination of the targeted methods studied has been shown to be effective and safe. Carrying out a histofusion biopsy using a unified technique allows obtaining information on the clinical and morphological characteristics of prostate adenocarcinoma, which in terms of prognostic value is practically not inferior to the data of a cognitive biopsy performed taking into account the results of MRI. The use of targeted prostate biopsy methods increases the detection of clinically significant prostate cancer without adversely affecting the safety of the procedure in conjunction with standard prostate biopsy.