MP53-03 THE EFFICIENCY OF MRI/US FUSION TARGETED PROSTATE BIOPSIES IN FINDING CLINICALLY SIGNIFICANT PROSTATE CANCER COMPARED TO STANDARD TEMPLATE BIOPSY (2014)

You have accessJournal of UrologyProstate Cancer: Detection & Screening II1 Apr 2014MP53-03 THE EFFICIENCY OF MRI/US FUSION TARGETED PROSTATE BIOPSIES IN FINDING CLINICALLY SIGNIFICANT PROSTATE CANCER COMPARED TO STANDARD TEMPLATE BIOPSY Rachel Rubin, M. Minhaj Siddiqui, Arvin George, Annerleim Walton-Diaz, Soroush Rais-Bahrami, Daniel Su, Nabeel Shakir, Jason Rothwax, Chinonyerem Okoro, Maria Merino, Baris Turkbey, Peter Choyke, Bradford Wood, and Peter Pinto Rachel RubinRachel Rubin More articles by this author , M. Minhaj SiddiquiM. Minhaj Siddiqui More articles by this author , Arvin GeorgeArvin George More articles by this author , Annerleim Walton-DiazAnnerleim Walton-Diaz More articles by this author , Soroush Rais-BahramiSoroush Rais-Bahrami More articles by this author , Daniel SuDaniel Su More articles by this author , Nabeel ShakirNabeel Shakir More articles by this author , Jason RothwaxJason Rothwax More articles by this author , Chinonyerem OkoroChinonyerem Okoro More articles by this author , Maria MerinoMaria Merino More articles by this author , Baris TurkbeyBaris Turkbey More articles by this author , Peter ChoykePeter Choyke More articles by this author , Bradford WoodBradford Wood More articles by this author , and Peter PintoPeter Pinto More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1634AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail Introduction and Objectives Localized prostate cancer is identifiable on multiparametric MRI and sampled accurately with MRI/US fusion targeted biopsies. Targeted biopsy can potentially allow for fewer biopsies per diagnosis of cancer. This study evaluates the efficiency of targeted biopsies in diagnosing prostate cancer. Methods From March 2007 to June 2013, 822 subjects enrolled in a prospective trial comparing systematic 12-core template transrectal ultrasound biopsies to targeted MRI/US fusion guided prostate biopsies performed during the same biopsy session. A total of 14,410 biopsy cores were reviewed. Biopsy efficiency was determined by dividing the number of total biopsies performed in each sub-group with the number of diagnoses from those biopsies. Results The median age was 62 years old (IQR 57-67) and median PSA 6.63 ng/ml (IQR 4.25-10.8). A mean of 12.2 template biopsies and 5.4 targeted biopsies were performed on each patient. Prostate cancer was diagnosed in 349 men (43% of the cohort) by targeted biopsy and 346 men (43%) by template biopsy. The proportion of these tumors that found to be clinically significant, high-grade (Gleason score ≥ 4+3) was 128 tumors on targeted (37%) versus 82 tumors on template biopsy (24%). We found that 3.7 biopsy cores were needed per diagnosis of any prostate cancer by targeted biopsy versus 7.6 cores by the template method. For Gleason score ≥ 4+3 cancer, 10.5 biopsy cores per diagnosis were needed by the targeted method versus 29.0 cores by the template method. Biopsy efficiency was also examined by MRI suspicion score and was found to be 10.4, 3.6, and 1.5 biopsies per diagnosis of any cancer for low, moderate, and high suspicion lesions. For the diagnosis of clinically significant high-grade tumors, the efficiency was 138.4, 12.8, and 2.7 biopsies per diagnosis for low, moderate, and high suspicion lesions. Conclusions Targeted biopsy diagnoses prostate cancer at a similar rate as extended sextant template, however a greater proportion of clinically significant high-grade tumors are found with targeted biopsy. Targeted biopsy is more efficient than template biopsy, requiring 53% fewer biopsies for all prostate cancer diagnoses and 74% fewer biopsies for high-grade prostate cancer diagnoses. Higher suspicion MRI lesions have even greater yield per biopsy. These findings have implications in future studies to decrease morbidity and improve cost-effectiveness of prostate biopsy. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e589 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Rachel Rubin More articles by this author M. Minhaj Siddiqui More articles by this author Arvin George More articles by this author Annerleim Walton-Diaz More articles by this author Soroush Rais-Bahrami More articles by this author Daniel Su More articles by this author Nabeel Shakir More articles by this author Jason Rothwax More articles by this author Chinonyerem Okoro More articles by this author Maria Merino More articles by this author Baris Turkbey More articles by this author Peter Choyke More articles by this author Bradford Wood More articles by this author Peter Pinto More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...