You have accessJournal of UrologyCME1 Apr 2023PD38-06 WHAT IS THE IDEAL NUMBER OF CORES TO COLLECT PER REGION OF INTEREST DURING TARGETED PROSTATE BIOPSY? Casey Brodsky, Ji Qi, Kathryn Marchetti, and John Wei Casey BrodskyCasey Brodsky More articles by this author , Ji QiJi Qi More articles by this author , Kathryn MarchettiKathryn Marchetti More articles by this author , and John WeiJohn Wei More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003336.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Over the past decade, magnetic resonance imaging (MRI)-guided targeted prostate biopsy has been gaining favor over 12-core systematic biopsy for more accurate detection of clinically significant prostate cancers; however, no guidelines exist regarding the optimal number of biopsy cores that should be taken per region of interest (ROI) identified on MRI. An ideal number of cores balances maximizing cancer detection while minimizing patient discomfort, procedure time, and infection risk. In this project, we analyze the prostate cancer detection rate depending on core number for a large patient cohort. METHODS: Patients receiving targeted prostate cancer biopsy at the University of Michigan between January 2017 and June 2022 were identified. For each biopsy, 12 systematic cores were taken, as well as 4 cores per ROI. Statistical simulation was performed in SAS, using 500 iterations randomizing the order of cores taken, to assess cancer detection rate (CDR) and clinically significant cancer detection rate (CSCDR, defined as Gleason grade group ≥2) if 1, 2, or 3 versus 4 cores were taken per ROI. Chi-square tests were used to compare CDR and CSCDR between different scenarios. RESULTS: We identified 1022 patients, with 1095 total ROIs biopsied. Median age at time of biopsy was 65 (IQR 60-71), and median pre-biopsy PSA was 6.7 ng/mL (IQR 4.9-9.5). On systematic 12-core biopsy, CDR and CSCDR were 60% and 31%, respectively. On targeted biopsy considering all 4 cores, CDR and CSCDR were 59% and 39%, respectively. Combined biopsy considering systematic 12-core plus 4-core targeted biopsy showed CDR and CSCDR of 70% and 44%, respectively. Compared to taking 4 cores per ROI, taking fewer than 4 cores resulted in a decrease in both CDR and CSCDR, with statistically significant decreases seen for 1 and 2 versus 4 cores (Figure 1). This effect is mitigated when both targeted and systematic biopsy were combined. CONCLUSIONS: These analyses indicate that relative to 4 cores per ROI, cancer detection was inferior when only 1 or 2 cores are taken, but that 3 cores was not clinically nor statistically different than 4 cores. Source of Funding: N/A © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e995 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Casey Brodsky More articles by this author Ji Qi More articles by this author Kathryn Marchetti More articles by this author John Wei More articles by this author Expand All Advertisement PDF downloadLoading ...