Optimal sampling scheme in men with abnormal multiparametric MRI undergoing MRI-TRUS fusion prostate biopsy

Yuval Freifeld, Yin Xi, Niccolo Passoni, Solomon Woldu, Brad Hornberger, Kenneth Allen Goldberg, Aditya Bagrodia, Ganesh Raj, Vitaly Margulis, Jeffrey A Cadeddu, Yair Lotan, Franto Francis, Ivan Pedrosa, Claus G. Roehrborn, Daniel N Costa

Research output: Contribution to journalArticle

Abstract

Objectives: To determine the implications of different prostate sampling schemes on the diagnosis of clinically significant prostate cancer (csPCA, ISUP group 2–5) and clinically insignificant prostate cancer (ciPCA, ISUP group 1) in men with abnormal multiparametric magnetic resonance imaging (mpMRI) undergoing MRI-transrectal ulrasound fusion targeted biopsies. Materials and Methods: This is a retrospective analysis of a cohort including all men who had a single lesion on mpMRI of the prostate performed between January 2016 and June 2017. All men underwent an MRI-transrectal ulrasound fusion biopsy and systematic (SBx) sampling of the prostate, which combined and were considered the standard of reference. The hypothetical 3 biopsy sampling schemes were defined as follows: Targeted biopsy only (TBx), TBx + ipsilateral SBx (ipsi-SBx) and TBx + contralateral SBx (contra-SBx) and were evaluated for the detection of csPCA and ciPCA. Sensitivity and 95% intervals were calculated, McNemar test was used to compare sensitivities between the various sampling schemes. Results: TBx + SBx detected csPCa in 47% (55 of 116) of the 116 men who met eligibility criteria. Sensitivity and 95% confidence intervals for csPCa detection was 85.5% (73.3%–93.5%), 96.4% (87.5%–99.6%), and 92.7 (82.4%–98%) for TBx alone, TBx + ipsi-SBx and TBx + contra-SBx, respectively. csPCa detection rates were higher for both TBx + ipsi-SBx and TBx + contra-SBx compared to TBx alone. Clinically insignificant cancers alone were detected in 7.7% (9 of 116), 10.3% (12 of 116), and 14.6% (17 of 116) of the cohort by TBx only and TBx + ipsi-SBx, and TBx + contra-SBx, respectively. Conclusions: TBx + ipsi-SBx may increase the detection of csPCa while limiting overdiagnosis of indolent cancers.

Original languageEnglish (US)
JournalUrologic Oncology: Seminars and Original Investigations
DOIs
StateAccepted/In press - Jan 1 2018

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Prostate
Biopsy
Prostatic Neoplasms
Magnetic Resonance Imaging
Neoplasms
Cohort Studies
Confidence Intervals

Keywords

  • Biopsy
  • MRI
  • Prostate
  • Prostate cancer
  • Systematic biopsy
  • Targeted biopsy

ASJC Scopus subject areas

  • Oncology
  • Urology

Cite this

@article{a70d38b45ba6418385af840a00437fa5,
title = "Optimal sampling scheme in men with abnormal multiparametric MRI undergoing MRI-TRUS fusion prostate biopsy",
abstract = "Objectives: To determine the implications of different prostate sampling schemes on the diagnosis of clinically significant prostate cancer (csPCA, ISUP group 2–5) and clinically insignificant prostate cancer (ciPCA, ISUP group 1) in men with abnormal multiparametric magnetic resonance imaging (mpMRI) undergoing MRI-transrectal ulrasound fusion targeted biopsies. Materials and Methods: This is a retrospective analysis of a cohort including all men who had a single lesion on mpMRI of the prostate performed between January 2016 and June 2017. All men underwent an MRI-transrectal ulrasound fusion biopsy and systematic (SBx) sampling of the prostate, which combined and were considered the standard of reference. The hypothetical 3 biopsy sampling schemes were defined as follows: Targeted biopsy only (TBx), TBx + ipsilateral SBx (ipsi-SBx) and TBx + contralateral SBx (contra-SBx) and were evaluated for the detection of csPCA and ciPCA. Sensitivity and 95{\%} intervals were calculated, McNemar test was used to compare sensitivities between the various sampling schemes. Results: TBx + SBx detected csPCa in 47{\%} (55 of 116) of the 116 men who met eligibility criteria. Sensitivity and 95{\%} confidence intervals for csPCa detection was 85.5{\%} (73.3{\%}–93.5{\%}), 96.4{\%} (87.5{\%}–99.6{\%}), and 92.7 (82.4{\%}–98{\%}) for TBx alone, TBx + ipsi-SBx and TBx + contra-SBx, respectively. csPCa detection rates were higher for both TBx + ipsi-SBx and TBx + contra-SBx compared to TBx alone. Clinically insignificant cancers alone were detected in 7.7{\%} (9 of 116), 10.3{\%} (12 of 116), and 14.6{\%} (17 of 116) of the cohort by TBx only and TBx + ipsi-SBx, and TBx + contra-SBx, respectively. Conclusions: TBx + ipsi-SBx may increase the detection of csPCa while limiting overdiagnosis of indolent cancers.",
keywords = "Biopsy, MRI, Prostate, Prostate cancer, Systematic biopsy, Targeted biopsy",
author = "Yuval Freifeld and Yin Xi and Niccolo Passoni and Solomon Woldu and Brad Hornberger and Goldberg, {Kenneth Allen} and Aditya Bagrodia and Ganesh Raj and Vitaly Margulis and Cadeddu, {Jeffrey A} and Yair Lotan and Franto Francis and Ivan Pedrosa and {G. Roehrborn}, Claus and Costa, {Daniel N}",
year = "2018",
month = "1",
day = "1",
doi = "10.1016/j.urolonc.2018.10.009",
language = "English (US)",
journal = "Urologic Oncology: Seminars and Original Investigations",
issn = "1078-1439",
publisher = "Elsevier Inc.",

}

TY - JOUR

T1 - Optimal sampling scheme in men with abnormal multiparametric MRI undergoing MRI-TRUS fusion prostate biopsy

AU - Freifeld, Yuval

AU - Xi, Yin

AU - Passoni, Niccolo

AU - Woldu, Solomon

AU - Hornberger, Brad

AU - Goldberg, Kenneth Allen

AU - Bagrodia, Aditya

AU - Raj, Ganesh

AU - Margulis, Vitaly

AU - Cadeddu, Jeffrey A

AU - Lotan, Yair

AU - Francis, Franto

AU - Pedrosa, Ivan

AU - G. Roehrborn, Claus

AU - Costa, Daniel N

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Objectives: To determine the implications of different prostate sampling schemes on the diagnosis of clinically significant prostate cancer (csPCA, ISUP group 2–5) and clinically insignificant prostate cancer (ciPCA, ISUP group 1) in men with abnormal multiparametric magnetic resonance imaging (mpMRI) undergoing MRI-transrectal ulrasound fusion targeted biopsies. Materials and Methods: This is a retrospective analysis of a cohort including all men who had a single lesion on mpMRI of the prostate performed between January 2016 and June 2017. All men underwent an MRI-transrectal ulrasound fusion biopsy and systematic (SBx) sampling of the prostate, which combined and were considered the standard of reference. The hypothetical 3 biopsy sampling schemes were defined as follows: Targeted biopsy only (TBx), TBx + ipsilateral SBx (ipsi-SBx) and TBx + contralateral SBx (contra-SBx) and were evaluated for the detection of csPCA and ciPCA. Sensitivity and 95% intervals were calculated, McNemar test was used to compare sensitivities between the various sampling schemes. Results: TBx + SBx detected csPCa in 47% (55 of 116) of the 116 men who met eligibility criteria. Sensitivity and 95% confidence intervals for csPCa detection was 85.5% (73.3%–93.5%), 96.4% (87.5%–99.6%), and 92.7 (82.4%–98%) for TBx alone, TBx + ipsi-SBx and TBx + contra-SBx, respectively. csPCa detection rates were higher for both TBx + ipsi-SBx and TBx + contra-SBx compared to TBx alone. Clinically insignificant cancers alone were detected in 7.7% (9 of 116), 10.3% (12 of 116), and 14.6% (17 of 116) of the cohort by TBx only and TBx + ipsi-SBx, and TBx + contra-SBx, respectively. Conclusions: TBx + ipsi-SBx may increase the detection of csPCa while limiting overdiagnosis of indolent cancers.

AB - Objectives: To determine the implications of different prostate sampling schemes on the diagnosis of clinically significant prostate cancer (csPCA, ISUP group 2–5) and clinically insignificant prostate cancer (ciPCA, ISUP group 1) in men with abnormal multiparametric magnetic resonance imaging (mpMRI) undergoing MRI-transrectal ulrasound fusion targeted biopsies. Materials and Methods: This is a retrospective analysis of a cohort including all men who had a single lesion on mpMRI of the prostate performed between January 2016 and June 2017. All men underwent an MRI-transrectal ulrasound fusion biopsy and systematic (SBx) sampling of the prostate, which combined and were considered the standard of reference. The hypothetical 3 biopsy sampling schemes were defined as follows: Targeted biopsy only (TBx), TBx + ipsilateral SBx (ipsi-SBx) and TBx + contralateral SBx (contra-SBx) and were evaluated for the detection of csPCA and ciPCA. Sensitivity and 95% intervals were calculated, McNemar test was used to compare sensitivities between the various sampling schemes. Results: TBx + SBx detected csPCa in 47% (55 of 116) of the 116 men who met eligibility criteria. Sensitivity and 95% confidence intervals for csPCa detection was 85.5% (73.3%–93.5%), 96.4% (87.5%–99.6%), and 92.7 (82.4%–98%) for TBx alone, TBx + ipsi-SBx and TBx + contra-SBx, respectively. csPCa detection rates were higher for both TBx + ipsi-SBx and TBx + contra-SBx compared to TBx alone. Clinically insignificant cancers alone were detected in 7.7% (9 of 116), 10.3% (12 of 116), and 14.6% (17 of 116) of the cohort by TBx only and TBx + ipsi-SBx, and TBx + contra-SBx, respectively. Conclusions: TBx + ipsi-SBx may increase the detection of csPCa while limiting overdiagnosis of indolent cancers.

KW - Biopsy

KW - MRI

KW - Prostate

KW - Prostate cancer

KW - Systematic biopsy

KW - Targeted biopsy

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U2 - 10.1016/j.urolonc.2018.10.009

DO - 10.1016/j.urolonc.2018.10.009

M3 - Article

JO - Urologic Oncology: Seminars and Original Investigations

JF - Urologic Oncology: Seminars and Original Investigations

SN - 1078-1439

ER -