PD06-04 MIDLINE PROSTATE LESIONS: FUSION BIOPSY IMPROVES DETECTION OF CLINICALLY SIGNIFICANT CANCER

Abstract

You have accessJournal of UrologyImaging/Radiology: Uroradiology II1 Apr 2016PD06-04 MIDLINE PROSTATE LESIONS: FUSION BIOPSY IMPROVES DETECTION OF CLINICALLY SIGNIFICANT CANCER Akhil Muthigi, Arvin George, Michael Kongnyuy, Abhinav Sidana, Nabeel Shakir, Meet Kadakia, Amichai Kilchevsky, Thomas Frye, Daniel Su, Maria Merino, Baris Turkbey, Peter Choyke, Bradford Wood, and Peter Pinto Akhil MuthigiAkhil Muthigi More articles by this author , Arvin GeorgeArvin George More articles by this author , Michael KongnyuyMichael Kongnyuy More articles by this author , Abhinav SidanaAbhinav Sidana More articles by this author , Nabeel ShakirNabeel Shakir More articles by this author , Meet KadakiaMeet Kadakia More articles by this author , Amichai KilchevskyAmichai Kilchevsky More articles by this author , Thomas FryeThomas Frye More articles by this author , Daniel SuDaniel Su More articles by this author , Maria MerinoMaria Merino More articles by this author , Baris TurkbeyBaris Turkbey More articles by this author , Peter ChoykePeter Choyke More articles by this author , Bradford WoodBradford Wood More articles by this author , and Peter PintoPeter Pinto More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.2624AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES MRI-TRUS fusion biopsy (FBx) has proven efficacy in targeting suspicious areas that are traditionally missed by standard 12-core biopsy (SBx), such as anterior, distal apical, and subcapsular lesions. Midline lesions may be undersampled with medial biopsy cores during SBx unless large enough to enter the sampling area. The aim of our study was to determine the utility of FBx for targeting midline lesions identified on multiparametric MRI (mpMRI). METHODS A review was performed of a prospectively maintained database of patients undergoing mpMRI followed by FBx and SBx in the same session from 2007-2015. Patients with midline lesions of the prostate in the peripheral and transition zones were identified. Midline location was defined as any lesion crossing the midline on axial imaging and involving both prostatic lobes. Index lesion was defined as the lesion with highest Gleason score on biopsy. Patient demographic, imaging, and histopathologic data were collected. Chi-square and Wilcoxon rank-sum tests were conducted to determine association of patient, MRI, and biopsy pathology characteristics with disease upgrading based on FBx of midline lesions over SBx. RESULTS Out of 1260 patients, we identified 252 midline lesions in 190 patients (mean age 63.2 ± 7.36; median PSA 7.5 ng/dL). Of the 252 midline lesions, 128 (50.8%) had prostate cancer detected by fusion biopsy. In patients with prostate cancer found on biopsy (132/190), a midline target represented the index lesion of the prostate in 65 patients (49.2%). Prostate cancer detection in midline lesions was significantly correlated with upgrading on FBx relative to SBx (p<0.001). Disease risk category upgrading based on FBx of a midline lesion as compared to the highest SBx result occurred in 45/132 patients (34.1%). 41/45 upgrades (91%) were to intermediate (Gleason 7) or high risk (Gleason ≥ 8) cancer. Patients who were upgraded on FBx of midline lesions had significantly smaller MRI prostate volumes (Table 1). CONCLUSIONS MRI-TRUS fusion biopsy allows for targeted sampling of midline lesions missed with standard biopsy alone. Integration of mpMRI and FBx for sampling of midline lesions improves detection of clinically significant prostate cancer. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e175 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Akhil Muthigi More articles by this author Arvin George More articles by this author Michael Kongnyuy More articles by this author Abhinav Sidana More articles by this author Nabeel Shakir More articles by this author Meet Kadakia More articles by this author Amichai Kilchevsky More articles by this author Thomas Frye More articles by this author Daniel Su More articles by this author Maria Merino More articles by this author Baris Turkbey More articles by this author Peter Choyke More articles by this author Bradford Wood More articles by this author Peter Pinto More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...