PD57-01 MR/US FUSION-GUIDED PROSTATE BIOPSY IMPROVES CLINICALLY SIGNIFICANT PROSTATE CANCER DETECTION FOR BIOPSY-NAIVE PATIENTS ACROSS DIVERSE PRACTICE SETTINGS

Abstract

You have accessJournal of UrologyProstate Cancer: Staging II (PD57)1 Apr 2020PD57-01 MR/US FUSION-GUIDED PROSTATE BIOPSY IMPROVES CLINICALLY SIGNIFICANT PROSTATE CANCER DETECTION FOR BIOPSY-NAIVE PATIENTS ACROSS DIVERSE PRACTICE SETTINGS Brett Watson*, MD Ji Qi, Anna Johnson, and for the Michigan Urological Surgery Improvement Collaborative Brett Watson*Brett Watson* More articles by this author , Ji QiJi Qi More articles by this author , Anna JohnsonAnna Johnson More articles by this author , and for the Michigan Urological Surgery Improvement Collaborative More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000967.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Multicenter trials have compared fusion to systematic prostate biopsy in the biopsy-naive population. These reports are predominantly from large academic centers with significant expertise. However, the added value of MR targeted biopsy for biopsy-naive patients in the community setting is largely unknown. METHODS: The Michigan Urological Surgery Improvement Collaborative (MUSIC) registry maintains a prospective MR and fusion biopsy database with technical, patient, provider, and lesion level data. All patients undergoing targeted and systematic biopsy in the same setting with no prior biopsy from August 2017 - May 2019 were included. Software-based MR/US fusion was used in all cases. Primary outcomes were the proportion of patients upgraded to ≥GG2 prostate cancer (PCa) by target and the proportion upgraded to ≥GG2 PCa based on systematic biopsy. RESULTS: Of 2375 fusion biopsies in the registry, 437 patients from 22 practices met inclusion criteria. Median age and pre-diagnosis PSA for the cohort was 66 years and 6.3 ng/ml, respectively. Overall cancer detection rate was 76.4% and the rate of clinically significant prostate cancer (csPCa) detection was 51.9%. Of the 227 cases of csPCa, 16% were detected by standard biopsy only, 17% by targeted biopsy only, and 67% by both techniques. Of all patients, 39 (8.9%) were upgraded to csPCa by targeted biopsy while 36 (8.2%) were upgraded to csPCa by standard biopsy. On bivariate analysis, we did not identify significant factors predictive of upgrading to csPCa by either technique. CONCLUSIONS: In biopsy-naïve patients, targeted biopsy upgrades approximately 1 in 10 patients to ≥GG2 prostate cancer. A similar proportion of patients with negative targeted biopsies were upgraded by systematic biopsy alone. There were no clinical variables associated with upgrading to ≥GG2 PCa by either biopsy method. Our findings suggest there is value in the community setting to adding mpMRI with targeted biopsy to the initial evaluation of biopsy-naive patients. Source of Funding: MUSIC is funded by Blue Cross Blue Shield of Michigan © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e1193-e1193 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Brett Watson* More articles by this author Ji Qi More articles by this author Anna Johnson More articles by this author for the Michigan Urological Surgery Improvement Collaborative More articles by this author Expand All Advertisement PDF downloadLoading ...