MP56-03 DIRECT VERSUS FUSION MAGNETIC RESONANCE IMAGING TARGETED BIOPSY OF THE PROSTATE: A RETROSPECTIVE MULTIVARIABLE COMPARATIVE ANALYSIS WITH PROPENSITY SCORE WEIGHTING

Abstract

You have accessJournal of UrologyProstate Cancer: Detection & Screening IV (MP56)1 Apr 2020MP56-03 DIRECT VERSUS FUSION MAGNETIC RESONANCE IMAGING TARGETED BIOPSY OF THE PROSTATE: A RETROSPECTIVE MULTIVARIABLE COMPARATIVE ANALYSIS WITH PROPENSITY SCORE WEIGHTING Morgan Prince*, Bryan Foster, Andy Kaempf, Yiyi Chen, Jen-Jane Liu, Christopher Amling, and Fergus Coakley Morgan Prince*Morgan Prince* More articles by this author , Bryan FosterBryan Foster More articles by this author , Andy KaempfAndy Kaempf More articles by this author , Yiyi ChenYiyi Chen More articles by this author , Jen-Jane LiuJen-Jane Liu More articles by this author , Christopher AmlingChristopher Amling More articles by this author , and Fergus CoakleyFergus Coakley More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000925.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Evolution of multiparametric prostate magnetic resonance (MR) imaging in recent years has facilitated new prostate biopsy techniques, including direct and fusion biopsies. Few studies have compared these two techniques directly, and those that have are conflicting. Our objective was to compare the positive biopsy rate of direct versus fusion MR imaging targeted biopsy of the prostate using a retrospective multivariable regression that incorporates propensity score weights. METHODS: We retrospectively identified patients with unknown or untreated low risk prostate cancer who underwent MR imaging targeted fusion or direct “in bore” biopsy of one or more suspicious prostate lesions as identified on multiparametric MR imaging. Both fusion and direct biopsy techniques were introduced at our institution within the last five years, and patients were referred based on physician choice. Pre-biopsy multiparametric MR images were blindly re-analyzed to determine target size, location (peripheral zone or central gland), and PIRADS version 2 score. Patient history (no prior biopsy, prior biopsy negative, or prior biopsy positive on active surveillance) and targeted biopsy results were collated by review of our institutional electronic medical record. RESULTS: The final study population (n=326) consisted of 208 men who underwent direct biopsy of 236 targets and 118 men who underwent fusion biopsy of 136 targets (total of 372 biopsied targets). We observed a significantly higher positive biopsy rate for direct biopsy as compared to fusion biopsy, at 75.4% (178/236) versus 57.4% (78/136); Fisher’s exact test p < 0.001. After applying propensity score weighting to account for differences between groups and statistically adjusting for covariates using multivariable logistic regression, the likelihood of a positive result remained significantly higher for direct biopsy versus fusion biopsy (odds ratio = 2.41, 95% confidence interval = 1.30 – 4.46; p = 0.005). CONCLUSIONS: In our retrospective institutional experience, direct MRI targeted biopsy of the prostate significantly outperforms fusion targeted biopsy. The superiority of the direct approach should be a consideration when patients are referred for MRI-targeted biopsy. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e848-e848 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Morgan Prince* More articles by this author Bryan Foster More articles by this author Andy Kaempf More articles by this author Yiyi Chen More articles by this author Jen-Jane Liu More articles by this author Christopher Amling More articles by this author Fergus Coakley More articles by this author Expand All Advertisement PDF downloadLoading ...