1. Combining targeted and systematic prostate biopsy improves prostate cancer detection and correlation with the whole mount histopathology in biopsy naïve and previous negative biopsy patients
- Author
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Johannes Mischinger, Helmut Schöllnast, Hanna Zurl, Mark Geyer, Katja Fischereder, Gabriel Adelsmayr, Jasminka Igrec, Gerald Fritz, Martina Merdzo-Hörmann, Jörg Elstner, Johannes Schmid, Alfred Triebl, Viktoria Trimmel, Clemens Reiter, Jakob Steiner, Dominik Rosenlechner, Maximilian Seles, Georg P. Pichler, Martin Pichler, Jakob Riedl, Stephanie Schöpfer-Schwab, Jakob Strobl, Georg C. Hutterer, Richard Zigeuner, Karl Pummer, Herbert Augustin, Sascha Ahyai, Sebastian Mannweiler, Michael Fuchsjäger, and Emina Talakic
- Subjects
prostate cancer detection ,PI-RADS-Version-2 ,combination of fusion and systematic biopsy ,uroNav ,biopsy-naïve ,previous-negative biopsy ,Surgery ,RD1-811 - Abstract
ObjectiveGuidelines for previous negative biopsy (PNB) cohorts with a suspicion of prostate cancer (PCa) after positive multiparametric (mp) magnetic-resonance-imaging (MRI) often favour the fusion-guided targeted prostate-biopsy (TB) only approach for Prostate Imaging-Reporting and Data System (PI-RADS) ≥3 lesions. However, recommendations lack direct biopsy performance comparison within biopsy naïve (BN) vs. PNB patients and its prognostication of the whole mount pathology report (WMPR), respectively. We suppose, that the combination of TB and concomitant TRUS-systematic biopsy (SB) improves the PCa detection rate of PI-RADS 2, 3, 4 or 5 lesions and the International Society of Urological Pathology (ISUP)-grade predictability of the WMPR in BN- and PNB patients.MethodsPatients with suspicious mpMRI, elevated prostate-specific-antigen and/or abnormal digital rectal examination were included. All PI-RADS reports were intramurally reviewed for biopsy planning. We compared the PI-RADS score substratified TB, SB or combined approach (TB/SB) associated BN- and PNB-PCa detection rate. Furthermore, we assessed the ISUP-grade variability between biopsy cores and the WMPR.ResultsAccording to BN (n = 499) vs. PNB (n = 314) patients, clinically significant (cs) PCa was detected more frequently by the TB/SB approach (62 vs. 43%) than with the TB (54 vs. 34%) or SB (57 vs. 34%) (all p
- Published
- 2022
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