MP05-15 TRANSPERINEAL VS TRANSRECTAL MICRO-ULTRASOUND AND MPMRI TARGETED PROSTATE BIOPSIES: PROPENSITY SCORE-MATCHED STUDY

Abstract

You have accessJournal of UrologyProstate Cancer: Detection & Screening I (MP05)1 Sep 2021MP05-15 TRANSPERINEAL VS TRANSRECTAL MICRO-ULTRASOUND AND MPMRI TARGETED PROSTATE BIOPSIES: PROPENSITY SCORE-MATCHED STUDY Arnas Rakauskas, Max Peters, Paul Martel, Stefano La Rosa, Jean-Yves Meuwly, Beat Roth, and Massimo Valerio Arnas RakauskasArnas Rakauskas More articles by this author , Max PetersMax Peters More articles by this author , Paul MartelPaul Martel More articles by this author , Stefano La RosaStefano La Rosa More articles by this author , Jean-Yves MeuwlyJean-Yves Meuwly More articles by this author , Beat RothBeat Roth More articles by this author , and Massimo ValerioMassimo Valerio More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001972.15AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Micro-ultrasound (micro-US) is a novel US-based imaging modality that allows real-time targeted prostate biopsies with mpMRI fusion. Its high resolution relying on a 29 MHz transducer allows real-time visualisation of prostate cancer (PCa) lesions. Micro-US integrate a transperineal and a transrectal hardware which allows the operator to tailor the biopsy approach to each patient. We aimed to compare cancer detection rates in patients who underwent transrectal (TRUS-PB) versus transperineal MRI fusion guided micro-ultrasound biopsy (TPB). METHODS: Out of 322 biopsy procedures, 56 TRUS-PB and 266 TPB were carried-out. All prostate biopsies were performed using ExactVuTM system (Exact Imaging, Markham, Canada) with mpMRI image fusion. Systematic biopsies were performed in addition to targeted biopsy in both modalities. 1:2 propensity score match-pairing was performed prior to statistical comparison. Men with anterior lesions were excluded as it has already been shown that in this subgroup TPB perform better than TRUS-PB. Clinically significant disease (csPCa) was defined as Gleason pattern 4 or higher. Potential predictors for detection of csPCa were analysed by univariable and multivariable logistic regression. Detection rate of csPCa according to micro-US findings was also evaluated. RESULTS: 47 men undergoing TRUS-PB and 88 undergoing TPB were matched in terms of age, PSA, clinical stage, mpMRI score, number of mpMRI visible lesions, prostate volume, and indication to biopsy. The detection of csPCa was not different between two groups (44% TPB vs. 43% TRUS-PB, p=0.8). There was no statistically significant difference in likelihood to detect any PCa as well (55% TPB vs 57% TRUS-PB p = 0.7). Both approaches were equal in csPCa detection rates in targeted biopsies only (31% TPB vs 28% TRUS-PB, p=0.6). Micro-US detected non-MR visible csPCa and insignificant disease in 13 (10%) and 12 (9%) men, respectively. In univariable analysis age, prostate volume and previous biopsy status were all associated with clinically significant PCa. In multivariate analysis only age and prostate volume remained independent predictors. CONCLUSIONS: In our initial experience, the detection rate of csPCa was high at 55-57% regardless the biopsy approach. TRUS-PB seems to be as precise as TPB, at least in sampling posterior areas. These findings might be related to the high resolution of micro-US allowing real-time visualisation of regions of interest and/or to the selected study population. These findings should be validated in a larger more homogeneous cohort. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e84-e84 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Arnas Rakauskas More articles by this author Max Peters More articles by this author Paul Martel More articles by this author Stefano La Rosa More articles by this author Jean-Yves Meuwly More articles by this author Beat Roth More articles by this author Massimo Valerio More articles by this author Expand All Advertisement Loading ...