PD15-03 MAGNETIC RESONANCE IMAGING/ULTRASOUND-FUSION BIOPSY BETTER PREDICTS WHOLE GLAND PATHOLOGY ON RADICAL PROSTATECTOMY COMPARED TO STANDARD 12-CORE BIOPSY (2014)

You have accessJournal of UrologyProstate Cancer: Staging I1 Apr 2014PD15-03 MAGNETIC RESONANCE IMAGING/ULTRASOUND-FUSION BIOPSY BETTER PREDICTS WHOLE GLAND PATHOLOGY ON RADICAL PROSTATECTOMY COMPARED TO STANDARD 12-CORE BIOPSY Arvin George, Daniel Su, Nabeel Shakir, Minhaj Siddiqui, Soroush Rais-Bahrami, Lambros Stamatakis, Jason Rothwas, Chinonyerem Okoro, Dima Raskolnikov, Annerleim Walton-Diaz, Maria Merino, Baris Turkbey, Bradford Wood, Peter Choyke, and Peter Pinto Arvin GeorgeArvin George More articles by this author , Daniel SuDaniel Su More articles by this author , Nabeel ShakirNabeel Shakir More articles by this author , Minhaj SiddiquiMinhaj Siddiqui More articles by this author , Soroush Rais-BahramiSoroush Rais-Bahrami More articles by this author , Lambros StamatakisLambros Stamatakis More articles by this author , Jason RothwasJason Rothwas More articles by this author , Chinonyerem OkoroChinonyerem Okoro More articles by this author , Dima RaskolnikovDima Raskolnikov More articles by this author , Annerleim Walton-DiazAnnerleim Walton-Diaz More articles by this author , Maria MerinoMaria Merino More articles by this author , Baris TurkbeyBaris Turkbey More articles by this author , Bradford WoodBradford Wood More articles by this author , Peter ChoykePeter Choyke More articles by this author , and Peter PintoPeter Pinto More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1292AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Standard 12-core prostate biopsy is associated with upgrading in 25-33% of patients at radical prostatectomy (RP). MRI/US fusion prostate biopsy has been shown to upgrade prostate cancer (CaP) from 12-core biopsy in 32% of the cases. MRI/US fusion biopsy is a potentially more accurate representation of whole gland pathology. We evaluate rate of pathologic upgrade in standard 12-core biopsy and MRI/US fusion biopsy compared to whole gland pathology from RP. METHODS A review of patients enrolled in a prospective trial evaluating MRI/US fusion prostate biopsies from March 2007 to June 2013 was performed. Patients who underwent 12-core, MRI/US fusion biopsy and subsequently RP for CaP were included. Pathology was reviewed by a single genitourinary pathologist. The cohort was further divided into clinically significant high-grade (Gleason score ≥ 4+3) and clinically insignificant low-grade (Gleason score ≤3+4) cohorts. Pathologic upgrade was defined as any increase in Gleason sum or primary Gleason score. Univariate and multivariate analysis was performed using the JMP statistical package (version 11; SAS Institute, Inc.) to analyze the association between upgrading from 12-core or targeted biopsy to final pathology at RP. RESULTS We identified 132 patients who underwent standard 12-core, MRI/US fusion biopsy, and subsequent RP. Mean PSA was 9.9ng/ml with a mean age of 61.1 years. Fusion biopsy upgraded 40 patients (30.3%) from 12-core biopsy, 12 of whom had a negative 12-core biopsy. There were 62 (46.9%) patients upgraded at RP compared to 47 (35.6%) from fusion to RP (p=0.041). There were 18 (13.5%) patients with clinically insignificant disease on 12-core biopsy and upgraded to clinically significant high-grade on RP, while only 7 (5.2%) in the fusion biopsy cohort (p=0.009) (Figure 1). There was no association with age, PSA, prostate volume, or BMI with upgrading on RP. CONCLUSIONS MRI/US fusion prostate biopsy has significantly lower pathologic upgrade rates of CaP versus standard 12-core biopsy at RP. MRI/US fusion biopsy represents whole gland pathology more accurately compared to 12-core biopsy, allowing for better-informed decision making prior to definitive therapy. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e416 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Arvin George More articles by this author Daniel Su More articles by this author Nabeel Shakir More articles by this author Minhaj Siddiqui More articles by this author Soroush Rais-Bahrami More articles by this author Lambros Stamatakis More articles by this author Jason Rothwas More articles by this author Chinonyerem Okoro More articles by this author Dima Raskolnikov More articles by this author Annerleim Walton-Diaz More articles by this author Maria Merino More articles by this author Baris Turkbey More articles by this author Bradford Wood More articles by this author Peter Choyke More articles by this author Peter Pinto More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...