MP09-03 COMPARATIVE STUDY OF SIGNIFICANT CANCER DETECTION IN MAGNETIC RESONANCE IMAGING-TRANSRECTAL ULTRASOUND FUSION IMAGE-GUIDED PROSTATE TARGET BIOPSY AND TRANSPERINEAL TEMPLATE-GUIDED SYSTEMATIC BIOPSY: A 15-CENTER PROSPECTIVE STUDY IN JAPAN

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP09-03 COMPARATIVE STUDY OF SIGNIFICANT CANCER DETECTION IN MAGNETIC RESONANCE IMAGING-TRANSRECTAL ULTRASOUND FUSION IMAGE-GUIDED PROSTATE TARGET BIOPSY AND TRANSPERINEAL TEMPLATE-GUIDED SYSTEMATIC BIOPSY: A 15-CENTER PROSPECTIVE STUDY IN JAPAN Sunao Shoji, Mayura Nakano, Kazuya Oda, Tatsuo Kano, Tatsuya Umemoto, Masayoshi Kawakami, Masahiro Nitta, Masanori Hasegawa, and Akira Miyajima Sunao ShojiSunao Shoji More articles by this author , Mayura NakanoMayura Nakano More articles by this author , Kazuya OdaKazuya Oda More articles by this author , Tatsuo KanoTatsuo Kano More articles by this author , Tatsuya UmemotoTatsuya Umemoto More articles by this author , Masayoshi KawakamiMasayoshi Kawakami More articles by this author , Masahiro NittaMasahiro Nitta More articles by this author , Masanori HasegawaMasanori Hasegawa More articles by this author , and Akira MiyajimaAkira Miyajima More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003224.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The objective of the present study was to evaluate the usefulness of magnetic resonance imaging (MRI)-transrectal ultrasound (TRUS) fusion image-guided prostate target biopsy in detecting biopsy-proven clinically significant prostate cancer (csPC) in a multicenter prospective study. METHODS: Patients with serum prostate specific antigen (PSA) levels ≤ 20 ng/m and suspected prostate cancer on multi-parametric MRI were enrolled from 2020 to 2021. For cancer-suspicious areas, each patient underwent a target biopsy and transperineal template-guided 12-core systematic biopsy. The csPC detection rates between target and systematic biopsies were compared. RESULTS: The study included 400 patients (15 centers). The median age was 69 years (47-85), median PSA was 7.32 ng/mL (1.41-19.98), median prostate volume was 35 cc (7.4-131), median number of target biopsies per patient was 1 (1-4), and median biopsy time was 9 minutes (5-41). CsPC detection rates of patients’ target and systematic biopsies were 59.3% and 49%, respectively (p<0.0001). In the pathological findings of target and systematic biopsy cores, csPC detection (57% vs. 10.4%, p<0.0001), cancer core length (6 mm vs. 3 mm, p<0.0001), and cancer core percent (38% vs. 18%, p<0.0001) were significantly higher in target biopsies than in systematic biopsies. On multivariable logistic regression analysis to predict csPC, age (OR 1.054, P=0.002), PSA value (OR 1.097, p=0.033), PSA density (OR 2.068, p<0.0001), highest PI-RADS category (OR 5.105, p<0.0001), and location of the lesion with highest PI-RADS category (TZ vs. PZ) (OR 0.488, p=0.004) were significant risk factors for detecting csPC. On multivariable logistic regression analysis to predict csPC in patients with PI-RADS categories 2 and 3, PSAD was a significant risk factor for detecting csPC (OR 3.665, p<0.0001). Areas under the receiver operating characteristic curve (AUC) for PSAD was significantly greater than non-discrimination for the detection of csPC in patients with PI-RADS categories 2 and 3 (AUC 0.751, p<0.0001). Using cut-off value: 0.150 ng/mL/cc, sensitivity, specificity, positive predictive value, and negative predictive value for detecting csPC were 92.5%, 45.3%, 41.6%, and 93.5%, respectively. CONCLUSIONS: MRI-TRUS fusion image-guided target biopsy was superior to systematic biopsy in detecting patients with csPC. Using a cut-off value of PSAD would avoid unnecessary biopsies for regions with PI-RADS categories 2 and 3. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e104 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Sunao Shoji More articles by this author Mayura Nakano More articles by this author Kazuya Oda More articles by this author Tatsuo Kano More articles by this author Tatsuya Umemoto More articles by this author Masayoshi Kawakami More articles by this author Masahiro Nitta More articles by this author Masanori Hasegawa More articles by this author Akira Miyajima More articles by this author Expand All Advertisement PDF downloadLoading ...