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Targeted transperineal biopsy of the prostate has limited additional benefit over background cores for larger MRI-identified tumors.
- Source :
-
World journal of urology [World J Urol] 2016 Apr; Vol. 34 (4), pp. 501-8. Date of Electronic Publication: 2015 Aug 04. - Publication Year :
- 2016
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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.<br />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).<br />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(3) for Group 1 (range 0.09-2.79 cm(3)) and 1.65 cm(3) for Group 2 (0.3-9.07 cm(3)), 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 %.<br />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 :
- Aged
Follow-Up Studies
Humans
Male
Middle Aged
Perineum
Reproducibility of Results
Retrospective Studies
Image-Guided Biopsy methods
Magnetic Resonance Imaging, Interventional methods
Neoplasm Grading methods
Prostate diagnostic imaging
Prostatic Neoplasms diagnosis
Ultrasonography, Interventional methods
Subjects
Details
- Language :
- English
- ISSN :
- 1433-8726
- Volume :
- 34
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- World journal of urology
- Publication Type :
- Academic Journal
- Accession number :
- 26238348
- Full Text :
- https://doi.org/10.1007/s00345-015-1650-0