PD38-10 ADDING SYSTEMATIC BIOPSY (SBX) TO MAGNETIC RESONANCE ULTRASOUND FUSION TARGETED BIOPSY (TBX) OF THE PROSTATE IN MEN WITH PREVIOUS NEGATIVE BIOPSY OR ENROLLED IN ACTIVE SURVEILLANCE PROGRAMS: A PROSPECTIVE SINGLE CENTER, RANDOMIZED, ANALYSIS

Abstract

You have accessJournal of UrologyProstate Cancer: Detection & Screening III (PD38)1 Apr 2020PD38-10 ADDING SYSTEMATIC BIOPSY (SBX) TO MAGNETIC RESONANCE ULTRASOUND FUSION TARGETED BIOPSY (TBX) OF THE PROSTATE IN MEN WITH PREVIOUS NEGATIVE BIOPSY OR ENROLLED IN ACTIVE SURVEILLANCE PROGRAMS: A PROSPECTIVE SINGLE CENTER, RANDOMIZED, ANALYSIS Angelo Porreca, Francesco Del Giudice*, Marco Giampaoli, Daniele D'Agostino, Daniele Romagnoli, Alessandro Del Rosso, Paolo Corsi, Martina Maggi, Matteo Ferro, Ottavio De Cobelli, Giuseppe Lucarelli, Riccardo Schiavina, Ettore De Berardinis, Alessandro Sciarra, and Gian Maria Busetto Angelo PorrecaAngelo Porreca More articles by this author , Francesco Del Giudice*Francesco Del Giudice* More articles by this author , Marco GiampaoliMarco Giampaoli More articles by this author , Daniele D'AgostinoDaniele D'Agostino More articles by this author , Daniele RomagnoliDaniele Romagnoli More articles by this author , Alessandro Del RossoAlessandro Del Rosso More articles by this author , Paolo CorsiPaolo Corsi More articles by this author , Martina MaggiMartina Maggi More articles by this author , Matteo FerroMatteo Ferro More articles by this author , Ottavio De CobelliOttavio De Cobelli More articles by this author , Giuseppe LucarelliGiuseppe Lucarelli More articles by this author , Riccardo SchiavinaRiccardo Schiavina More articles by this author , Ettore De BerardinisEttore De Berardinis More articles by this author , Alessandro SciarraAlessandro Sciarra More articles by this author , and Gian Maria BusettoGian Maria Busetto More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000917.010AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Magnetic resonance imaging (MRI) targeted biopsy (TBx) of the prostate demonstrated to improve detection rate (DR) of clinically significant prostate cancer (csPCa) in biopsy-naïve patients achieving strong level of evidence. Nevertheless, the csPCa yield for TBx alone versus TBx plus systematic biopsy (SBx) after accounting for overlapping of SBx cores with TBx cores, in prior-negative or active surveillance (AS) patients has not been well established. Objective is to investigate benefits in terms of detection rate and pathological stratification of PCa using contextual SBx during MRI-TBx. METHODS: Patients previously submitted to negative-SBx (cohort A) and those enrolled in an AS program (cohort B) who showed at least one suspicious area with a PIRADSv2 score ³ 3 were prospectively and randomly assigned to only TBx strategy vs TBx plus SBx strategy. SBx locations could not encompass the TBx sites, so that the results of each type of biopsy was independent and did not overlap. RESULTS: A total of 312 patients were included in the two cohorts (cohort A: 213 cases; cohort B: 99 cases). No significant differences were found in terms of overall PCa-DR (77,6% vs 69,6% respectively; p=0,36) and csPCa-DR (48,2% vs 60,9% respectively; p=0,12). The MRI-TBx alone cohort showed higher csPCa/PCa ratio (87,5% vs 62,2%; p=0,03). The MRI-TBx plus SBx group sub-analysis showed significantly higher csPCa-DR obtained at the MRI-TBx cores when compared to the SBx cores (43,7% vs 24,1%, respectively; p=0.01). Independently to age, PSA and PI-RADS score, either in re-biopsy (OR 0.43, 0.21 – 0.97) or AS (OR 0.46, 0.32 – 0.89) setting, SBx cores were negatively associated with the csPCa-DR when combined to TBx cores. CONCLUSIONS: MRI-TBx should be considered the elective method to perform prostate biopsy in patients with previous negative SBx and those considered for an AS program. Adding SBx samples to MRI-TBx didn’t improvedetection rate of csPCa. Source of Funding: none © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e805-e806 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Angelo Porreca More articles by this author Francesco Del Giudice* More articles by this author Marco Giampaoli More articles by this author Daniele D'Agostino More articles by this author Daniele Romagnoli More articles by this author Alessandro Del Rosso More articles by this author Paolo Corsi More articles by this author Martina Maggi More articles by this author Matteo Ferro More articles by this author Ottavio De Cobelli More articles by this author Giuseppe Lucarelli More articles by this author Riccardo Schiavina More articles by this author Ettore De Berardinis More articles by this author Alessandro Sciarra More articles by this author Gian Maria Busetto More articles by this author Expand All Advertisement PDF downloadLoading ...