MP16-17 CAN SYSTEMATIC BIOPSY BE SAFELY OMITTED IN THE ERA OF MRI/TRUS-FUSION TARGETED PROSTATE BIOPSY?

Abstract

You have accessJournal of UrologyProstate Cancer: Detection & Screening I1 Apr 2016MP16-17 CAN SYSTEMATIC BIOPSY BE SAFELY OMITTED IN THE ERA OF MRI/TRUS-FUSION TARGETED PROSTATE BIOPSY? Yasukazu Nakanishi, Hiroshi Fukushima, Minato Yokoyama, Madoka Kataoka, Ken-ichi Tobisu, and Fumitaka Koga Yasukazu NakanishiYasukazu Nakanishi More articles by this author , Hiroshi FukushimaHiroshi Fukushima More articles by this author , Minato YokoyamaMinato Yokoyama More articles by this author , Madoka KataokaMadoka Kataoka More articles by this author , Ken-ichi TobisuKen-ichi Tobisu More articles by this author , and Fumitaka KogaFumitaka Koga More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.2582AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Multi-parametric MRI (mpMRI) prior to prostate biopsy has been increasingly utilized for accurate diagnosis of significant cancer (SC) and avoidance of overdiagnosis of insignificant cancer (IC). Here, we assessed diagnostic performance of mpMRI/TRUS-fusion targeted biopsy (TgB) in comparison with that of systematic multisite biopsy (SyB) and asked if SyB can be safely omitted in diagnosing SC. METHODS From April 2013 to August 2015, 202 men with elevated PSA (<20 ng/ml) or abnormal DRE finding were enrolled in this study. All pts underwent mpMRI prior to biopsy. mpMRI findings were evaluated according to Prostate Imaging-Reporting and Data System (PI-RADS) and scores ≥3 were considered positive. All patients underwent transperineal 14-core SyB and those with mpMRI-positive lesions further underwent 4-core TgB per lesion using real-time virtual sonography (Arietta70, Hitachi-Aloka Medical). SC was defined as Gleason score ≥4+3 or maximum cancer length ≥5 mm. We evaluated the diagnostic performance of SyB ± TgB in detecting all cancer and SC. RESULTS The median (range) age and PSA levels were 69 years (45-82) and 7.8 ng/ml (1.6-19.6). Of the 202 men, 166 (82%) were positive for MRI. Detection rates of all cancer, SC and IC were 58% (117/202), 44% (89/202) and 14% (28/202), respectively, and 16% (32/202) were categorized to NCCN high-risk disease. TgB showed significantly higher SC detection rate and lower IC detection rate than SyB (47% vs 36%, p = 0.03; and 7% vs 35%, p = 0.004; respectively). TgB alone detected 88% of SC (78/89) and more importantly 97% of high-risk disease (31/32). CONCLUSIONS Most of clinically significant diseases were diagnosed by MRI/TRUS-fusion targeted biopsy alone. Our data suggest that multisite systematic biopsy can be safely omitted in the era of MRI/TRUS-fusion targeted biopsy depending on the patient's general condition. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e167 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Yasukazu Nakanishi More articles by this author Hiroshi Fukushima More articles by this author Minato Yokoyama More articles by this author Madoka Kataoka More articles by this author Ken-ichi Tobisu More articles by this author Fumitaka Koga More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...