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- Title
Targeted transperineal biopsy of the prostate has limited additional benefit over background cores for larger MRI-identified tumors.
- Authors
Barrett, Tristan; Patterson, Andrew; Koo, Brendan; Wadhwa, Karan; Warren, Anne; Doble, Andrew; Gnanapragasam, Vincent; Kastner, Christof; Gallagher, Ferdia
- Abstract
Purpose: To compare histological outcomes in patients undergoing MRI-transrectal ultrasound fusion transperineal (MTTP) prostate biopsy and determine the incremental benefit of targeted cores. Methods: Seventy-six consecutive patients with 89 MRI-identified targets underwent MTTP biopsy. Separate targeted biopsies and background cores were obtained according to a standardized protocol. Target biopsies were considered of added diagnostic value if these cores showed a higher Gleason grade than non-targeted cores taken from the same sector (Group 1, n = 41). Conversely, where background cores demonstrated an equal or higher Gleason grade, target cores were considered to be non-beneficial (Group 2, n = 48). Results: There was no significant difference in age, PSA, prostate volume, time-to-biopsy, and number of cores obtained between the groups. A greater proportion of target cores were positive for cancer (158/228; 69.3 %) compared to background (344/1881; 18.38 %). The median target volume was 0.54 cm for Group 1 (range 0.09-2.79 cm) and 1.65 cm for Group 2 (0.3-9.07 cm), p < 0.001. The targets in Group 1 had statistically lower diameters for short and long axes, even after correction for gland size. The highest area under the receiver operating characteristic curve was demonstrated when a lesion cutoff value of 1.0 cm in short axis was applied, resulting in a sensitivity of 83.3 % and a specificity of 82.9 %. Conclusions: When a combined systematic and targeted transperineal prostate biopsy is performed, there is limited benefit in acquiring additional cores from larger-volume targets with a short axis diameter >1.0 cm.
- Subjects
DIAGNOSIS; PROSTATE cancer; PROSTATE biopsy; MAGNETIC resonance imaging; ENDORECTAL ultrasonography; GLEASON grading system; HEALTH outcome assessment
- Publication
World Journal of Urology, 2016, Vol 34, Issue 4, p501
- ISSN
0724-4983
- Publication type
Article
- DOI
10.1007/s00345-015-1650-0