Abstract
ObjectiveTarget biopsy (TB) was defined to detect a higher rate of cancer with fewer cores. Today, however, the combined biopsy (CB; TB + standard prostate biopsy (SPB)) with even more cores has become more popular. We aimed to compare CB results with those of TB and SPB in patients in the gray zone and, based on the outcomes, to determine whether TB has achieved its goal based on the expectation that higher cancer detection rates can be attained with fewer cores.Materials and methodsThis prospective study included patients with a prostate imaging reporting and data system (PI-RADS) ≥3 lesion and serum prostate-specific antigen (PSA) <10 ng/ml who underwent CB. All patients underwent two to five core biopsies per suspicious lesion (TB). Then, an SPB was administered to the same patients and in the same sessions. For fusion biopsy procedures, a fusion ultrasonography device with rigid software was used.ResultsA total of 404 patients were included in the study. The rate of clinically significant prostate cancer (sPCa) detection in TB, SPB, and CB was 30.2%, 25.5%, and 38.4%, respectively (p<0.05). The highest sPCa detection rate per core was detected in TB. For these patients, the CB results were accepted as the reference standard and then the histopathological upgrading of the lesions detected by SPB and TB was determined. Accordingly, higher histopathological upgrade rates were detected in SPB (10% and 25.7%).ConclusionWe can say that the philosophy of detecting more cancers with a low number of cores, which was created when defining TB, was partially unsuccessful.
Highlights
Prostate cancer (PCa) is the second most common cancer in men worldwide [1]
The combined biopsy (CB) results were accepted as the reference standard and the histopathological upgrading of the lesions detected by standard prostate biopsy (SPB) and Target biopsy (TB) was determined
Multiparametric magnetic resonance imaging-guided fusion prostate biopsy (FPB) has recently emerged as a promising technique, which is based on the prostate imaging reporting and data system (PI-RADS) scoring system and is performed in the form of cognitive, fusion, or in-bore biopsy using ultrasound fusion imaging with a computer program [4]
Summary
Prostate cancer (PCa) is the second most common cancer in men worldwide [1]. Digital rectal examination (DRE), serum prostate-specific antigen (PSA) test, and prostate needle biopsy are the most common procedures used in the diagnosis of PCa [2].Standard prostate biopsy (SPB) remains the golden standard in the diagnosis of PCa. Prostate cancer (PCa) is the second most common cancer in men worldwide [1]. Digital rectal examination (DRE), serum prostate-specific antigen (PSA) test, and prostate needle biopsy are the most common procedures used in the diagnosis of PCa [2]. Standard prostate biopsy (SPB) remains the golden standard in the diagnosis of PCa. it has been shown to result in a missed diagnosis of PCa in 21%-28% and to detect lower-grade tumors in 14%-17% of the cases [3]. A number of biopsy techniques have been developed in line with advancing technology. Multiparametric magnetic resonance imaging (mpMRI)-guided fusion prostate biopsy (FPB) has recently emerged as a promising technique, which is based on the prostate imaging reporting and data system (PI-RADS) scoring system and is performed in the form of cognitive, fusion, or in-bore biopsy using ultrasound fusion imaging with a computer program [4]
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