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MRI-targeted biopsy cores from prostate index lesions: assessment and prediction of the number needed

Authors :
Nick Lasse Beetz
Franziska Dräger
Charlie Alexander Hamm
Seyd Shnayien
Madhuri Monique Rudolph
Konrad Froböse
Sefer Elezkurtaj
Matthias Haas
Patrick Asbach
Bernd Hamm
Samy Mahjoub
Frank Konietschke
Maximilian Wechsung
Felix Balzer
Hannes Cash
Sebastian Hofbauer
Tobias Penzkofer
Source :
Prostate cancer and prostatic diseases.
Publication Year :
2022

Abstract

Background Magnetic resonance imaging (MRI) is used to detect the prostate index lesion before targeted biopsy. However, the number of biopsy cores that should be obtained from the index lesion is unclear. The aim of this study is to analyze how many MRI-targeted biopsy cores are needed to establish the most relevant histopathologic diagnosis of the index lesion and to build a prediction model. Methods We retrospectively included 451 patients who underwent 10-core systematic prostate biopsy and MRI-targeted biopsy with sampling of at least three cores from the index lesion. A total of 1587 biopsy cores were analyzed. The core sampling sequence was recorded, and the first biopsy core detecting the most relevant histopathologic diagnosis was identified. In a subgroup of 261 patients in whom exactly three MRI-targeted biopsy cores were obtained from the index lesion, we generated a prediction model. A nonparametric Bayes classifier was trained using the PI-RADS score, prostate-specific antigen (PSA) density, lesion size, zone, and location as covariates. Results The most relevant histopathologic diagnosis of the index lesion was detected by the first biopsy core in 331 cases (73%), by the second in 66 cases (15%), and by the third in 39 cases (9%), by the fourth in 13 cases (3%), and by the fifth in two cases ( Conclusion The most relevant histopathologic diagnosis of the index lesion was made on the basis of three MRI-targeted biopsy cores in 97% of patients. Our classifier can help in predicting the first MRI-targeted biopsy core revealing the most relevant histopathologic diagnosis; however, at least three MRI-targeted biopsy cores should be obtained regardless of the preinterventionally assessed covariates.

Subjects

Subjects :
Cancer Research
Oncology
Urology

Details

ISSN :
14765608
Database :
OpenAIRE
Journal :
Prostate cancer and prostatic diseases
Accession number :
edsair.doi.dedup.....e8383e89f367622a75bbbfb6617591b7