MP20-07 CONCORDANCE BETWEEN MRI FUSION VS TRUS PROSTATE BIOPSY AND FINAL PATHOLOGY AT RADICAL PROSTATECTOMY: DATA FROM THE PURC

Abstract

You have accessJournal of UrologyProstate Cancer: Detection & Screening II (MP20)1 Apr 2020MP20-07 CONCORDANCE BETWEEN MRI FUSION VS TRUS PROSTATE BIOPSY AND FINAL PATHOLOGY AT RADICAL PROSTATECTOMY: DATA FROM THE PURC Ruchika Talwar*, Katharine Michel, Aseem Malhotra, Bret Marlowe, Claudette Fonshell, John Danella, Serge Ginzberg, Bruce Jacobs, Thomas Lanchoney, Jay Raman, Eric Singer, Marc Smaldone, Jeffrey Tomaszewski, Edouard Trabulsi, Robert Uzzo, Daniel Lee, and Thomas Guzzo Ruchika Talwar*Ruchika Talwar* More articles by this author , Katharine MichelKatharine Michel More articles by this author , Aseem MalhotraAseem Malhotra More articles by this author , Bret MarloweBret Marlowe More articles by this author , Claudette FonshellClaudette Fonshell More articles by this author , John DanellaJohn Danella More articles by this author , Serge GinzbergSerge Ginzberg More articles by this author , Bruce JacobsBruce Jacobs More articles by this author , Thomas LanchoneyThomas Lanchoney More articles by this author , Jay RamanJay Raman More articles by this author , Eric SingerEric Singer More articles by this author , Marc SmaldoneMarc Smaldone More articles by this author , Jeffrey TomaszewskiJeffrey Tomaszewski More articles by this author , Edouard TrabulsiEdouard Trabulsi More articles by this author , Robert UzzoRobert Uzzo More articles by this author , Daniel LeeDaniel Lee More articles by this author , and Thomas GuzzoThomas Guzzo More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000853.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Studies suggest that MRI-fusion guided (MRI-fusion) biopsies are superior to the transrectal ultrasound guided (TRUS) technique. Herein, we present the Pennsylvania Urologic Regional Collaborative (PURC) experience with MRI fusion biopsy. We aimed to calculate concordance rates between TRUS prostate needle biopsy versus MRI fusion biopsy and final pathology at the time of radical prostatectomy within our cohort. METHODS: Within PURC, a prospective quality improvement collaborative of urology practices in Pennsylvania and New Jersey, we identified all men who underwent either a TRUS prostate needle biopsy, or an MRI fusion prostate needle biopsy, followed by radical prostatectomy for definitive treatment of prostate cancer from 2015 to 2018. We analyzed International Society of Urological Pathology Grade Group (GG) scoring and calculated the concordance and upgrading rates at the time of biopsy versus final pathology at radical prostatectomy. To assess for differences between our rates, we performed a test of equal proportions and Pearson's chi-squared test. We defined significance as p<0.05. RESULTS: We identified 1,437 patients who underwent TRUS (n =1247) or MRI Fusion (n=196) biopsies, followed by radical prostatectomy. Overall pathologic grading distribution at time of biopsy was: 35.8% (n=515) Grade Group (GG) 1, 28.5% (n=409) GG 2, 13.3% (n=191) GG 3, 11.5% (n=165) GG 4, and 10.9% (n=157) GG 5. Median number of cores at TRUS biopsy was 12 (IQR: 12,13). Median number of cores at MRI Fusion biopsy was 15 (IQR 13,18). Therefore, we inferred patients who underwent MRI Fusion biopsy also underwent standard TRUS biopsies at that time. Figure 1 illustrates differences in exact concordance rate between MRI fusion + TRUS and TRUS biopsies. The overall rate of upgrading on final pathology for MRI fusion +TRUS biopsies was 5.7% lower than for TRUS biopsies, but this was not statistically significant (35.2% vs 40.9%, 95% CI: 1.5-13.0%, p=0.06). CONCLUSIONS: MRI fusion plus TRUS biopsies demonstrated higher concordance rates with final pathology at the time of radical prostatectomy than TRUS prostate biopsies alone. Source of Funding: Data was provided with permission from the PURC, funded by participating urology practices and the Partnership for Patient Care, a quality improvement initiative supported by the Health Care Improvement Foundation, Independence Blue Cross, and southeastern PA hospitals and health systems. © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e309-e309 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ruchika Talwar* More articles by this author Katharine Michel More articles by this author Aseem Malhotra More articles by this author Bret Marlowe More articles by this author Claudette Fonshell More articles by this author John Danella More articles by this author Serge Ginzberg More articles by this author Bruce Jacobs More articles by this author Thomas Lanchoney More articles by this author Jay Raman More articles by this author Eric Singer More articles by this author Marc Smaldone More articles by this author Jeffrey Tomaszewski More articles by this author Edouard Trabulsi More articles by this author Robert Uzzo More articles by this author Daniel Lee More articles by this author Thomas Guzzo More articles by this author Expand All Advertisement PDF downloadLoading ...