Optimizing MRI-targeted prostate biopsy: The diagnostic benefit of additional targeted biopsy cores Journal Article
| Authors: | Tracy, C. R.; Flynn, K. J.; Sjoberg, D. D.; Gellhaus, P. T.; Metz, C. M.; Ehdaie, B. |
| Article Title: | Optimizing MRI-targeted prostate biopsy: The diagnostic benefit of additional targeted biopsy cores |
| Abstract: | Introduction: The optimal number of biopsy cores to obtain during MRI-targeted prostate biopsy remains ill-defined. This study sought to determine the optimal number of targeted biopsy cores to obtain from a region of interest to maximize detection of clinically significant prostate cancer. Materials and Methods: Consecutive patients undergoing MRI-targeted prostate biopsy at a single institution that newly implemented a targeted biopsy pathway from May 2017 to February 2018 were prospectively enrolled. Five biopsy cores were obtained and individually analyzed from each region rated ≥3 on PI-RADS v2.0 to determine the incremental diagnostic benefit of each additional targeted biopsy core. Variables associated with increasing Grade Group from the first to fifth biopsy core were assessed. Results: One hundred and four patients (79% for elevated PSA) were enrolled, 82% of which had a prior biopsy. Men with a PI-RADS >3 lesion were more likely to have pathologic upgrading with additional targeted biopsy cores (OR:4.76; 95% CI:2.34–9.70; P < 0.0001), particularly to Grade Group ≥2 (OR:5.16; 95% CI:2.17–12.29; P = 0.0002), compared to men with PI-RADS 3 lesions. Detection of clinically significant cancer increased from 26% to 44% to 52% when comparing the first, third, and fifth biopsy cores amongst men with a PI-RADS >3 lesion and from 1% to 4% to 9% for PI-RADS 3 lesions. Urinary retention was the most common complication, occurring in 6 (5.7%) patients. Conclusion: Clinically significant prostate cancer detection is improved with increased number of MRI-targeted biopsy cores, particularly for urologists early in their learning curve. © 2020 Elsevier Inc. |
| Keywords: | prostate cancer; pi-rads; fusion biopsy; mri targeted biopsies; multi-parametric prostate mri |
| Journal Title: | Urologic Oncology: Seminars and Original Investigations |
| Volume: | 39 |
| Issue: | 3 |
| ISSN: | 1078-1439 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2021-03-01 |
| Start Page: | 193.e1 |
| End Page: | 193.e6 |
| Language: | English |
| DOI: | 10.1016/j.urolonc.2020.09.019 |
| PUBMED: | 33127298 |
| PROVIDER: | scopus |
| PMCID: | PMC9060238 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 1 March 2021 -- Source: Scopus |
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