Multiparametric MRI-ultrasound fusion prostate biopsy in patients without prior diagnosis of prostate cancer: beyond centers of excellence. (9th April 2021)

• Record Type: Journal Article
• Authors: Verma, Sadhna; Zegar, Joseph; Hoge, Connor; McGready, John; Sidana, Abhinav
• Is Part Of: Aging male. Volume 23:Number 5(2020)
• Page Start: 1570
• Page End: 1575
• Publication Date: 2021-04-09
• Subjects: Prostate cancer -- prostate imaging -- fusion biopsy; Aging -- Periodicals; Men -- Periodicals; Gerontology -- Periodicals; Men -- Health and hygiene -- Periodicals; Aging -- periodicals; Geriatric -- periodicals; Men -- periodicals; Aged -- periodicals; Aged, 80 and over -- periodicals; 612.67
• DOI: 10.1080/13685538.2021.1873263
• Languages: English
• ISSNs: 1368-5538

Abstract

Abstract: Purpose: Multiparametric magnetic resonance imaging (mpMRI)-ultrasound (US) fusion prostate biopsy (FBx) has demonstrated increased accuracy for prostate cancer detection at designated centers of excellence. There is a concern if their results can be reproduced in smaller centers. Here, we evaluate the outcomes of FBx from a smaller academic center. Methods: A retrospective review of patients without a prior diagnosis of prostate cancer undergoing FBx from January 2014 to November 2019 was performed. Histopathological results were grouped into low-risk disease (Grade Group 1), intermediate-risk disease (Grade Group 2 and 3), and high-risk disease (Grade Group 4 or 5). Clinically significant (CS) prostate cancer was defined as Grade Group ≥ 2. Results: Five hundred and six men were included. Median age (IQR) and PSA (IQR) were 65.2 (60.3–70.2) years and 6.9 (5.2–9.7) ng/ml, respectively. There was no difference in overall cancer detection between FBx and SBx (53.6% vs 56.4% p = .1507). CS cancer detection was significantly higher with FBx (39.6% vs 35.3, p = .0275). FBx also outperformed SBx in diagnosing CS disease in patients with prior history of negative prostate biopsy (36.9% vs 27.9%, p < .001). Conclusion: FBx detects a higher proportion of clinically significant disease and a lower proportion of clinically insignificant disease compared to SBx, in line with outcomes demonstrated by centers of excellence.