The initial results of MRI-TRUS fusion prostate biopsy in high volume tertiary center.
| Title: | The initial results of MRI-TRUS fusion prostate biopsy in high volume tertiary center. |
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| Authors: | Smrkolj T; Department of Urology, Ljubljana University Medical Centre, Ljubljana, Slovenia.; Chair of Surgery, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.; Taskovska M; Department of Urology, Ljubljana University Medical Centre, Ljubljana, Slovenia.; Chair of Surgery, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.; Ditz I; Department of Urology, Ljubljana University Medical Centre, Ljubljana, Slovenia.; Chair of Surgery, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.; Cernelc K; Department of Urology, Ljubljana University Medical Centre, Ljubljana, Slovenia.; Hawlina S; Department of Urology, Ljubljana University Medical Centre, Ljubljana, Slovenia.; Chair of Surgery, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia. |
| Source: | Radiology and oncology [Radiol Oncol] 2024 Nov 28; Vol. 58 (4), pp. 501-508. Date of Electronic Publication: 2024 Nov 28 (Print Publication: 2024). |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: Sciendo Country of Publication: Poland NLM ID: 9317213 Publication Model: eCollection Cited Medium: Internet ISSN: 1581-3207 (Electronic) Linking ISSN: 13182099 NLM ISO Abbreviation: Radiol Oncol Subsets: MEDLINE |
| Imprint Name(s): | Publication: [Warsaw, Poland] : Sciendo; Original Publication: Ljubljana : Slovenian Medical Society, Section of Radiology [and] Croatian Medical Association, Croatian Society of Radiology, [1992- |
| MeSH Terms: | Prostatic Neoplasms*/pathology ; Prostatic Neoplasms*/diagnostic imaging ; Image-Guided Biopsy*/methods; Prostate/pathology ; Prostate/diagnostic imaging ; Multiparametric Magnetic Resonance Imaging/methods ; Ultrasonography, Interventional/methods ; Magnetic Resonance Imaging/methods ; Multimodal Imaging/methods ; Hospitals, High-Volume/statistics & numerical data ; Humans ; Male ; Aged ; Middle Aged ; Learning Curve ; Tertiary Care Centers ; Neoplasm Grading ; Retrospective Studies |
| Abstract: | Background: Multiparametric magnetic resonance imaging (mpMRI) is a prerequisite for targeted prostate biopsy. The aim of our study was to evaluate the performance and learning curve of the mpMRI-transrectal ultrasound (TRUS) software image fusion (MRI-TRUS fusion) biopsy (BX) process in the first year after its introduction in our urology department.; Patients and Methods: MRI-TRUS fusion BX was performed in 293 patients with at least one Prostate Imaging-Reporting and Data System (PIRADS) ≥3 lesion. The proportion of patients and lesions with positive histopathologic result for prostate cancer (PCa) was analyzed. The learning curve for MRI-TRUS fusion BX was assessed at institutional and individual level. Positive BX lesions were further analyzed by PIRADS and Gleason scores.; Results: The proportion of patients with positive histopathologic results for targeted BX, systematic BX, and combined BX was 53.9%, 47.9%, and 63.5%, respectively. The chi-square test for the proportion of PCa positive patients showed no significant difference between the time-based patient groups at the institutional level and no significant difference between individual urologists. PIRADS score (p < 0.001), total PSA concentration (p = 0.05), prostate volume (p < 0.001) and number of cores per lesion (p = 0.034) were significant predictors of a positive histopathologic result in a lesion-based analysis. Clinically significant PCa (csPCa) was confirmed in 34.7% of the 412 BX lesions and 76.4% of the 187 positive PCa lesions.; Conclusions: MRI-TRUS fusion targeted BX significantly improves the overall rate of PCa detection compared with systematic BX alone. No steep learning curve was observed in our urologists. The proportion of lesions with clinically insignificant PCa was low, limiting overdiagnosis of PCa.; (© 2024 Tomaz Smrkolj et al., published by Sciendo.) |
| References: | Culp MB, Soerjomataram I, Efstathiou JA, Bray F and Jemal A. Recent global patterns in prostate cancer incidence and mortality rates. Eur Urol 2020; 77: 38–52. doi: 10.1016/j.eururo.2019.08.005. (PMID: 10.1016/j.eururo.2019.08.005); Zadnik V, Gašljević G, Hočevar M, Jarm K, Pompe-Kirn V, Strojan P, et al. Cancer in Slovenia 2019 . [Internet]. Oncology Institute Ljubljana. Cancer Epidemiology and Registry. Cancer Registry of the Republic of Slovenia; 2022. p. 1–65. [cited 2024 May 27]. Available at: https://www.onko-i.si/rrs.; Cornford P, Tilki D, van den Bergh RCN, Briers E, Eberli D, De Meerleer M, et al. Prostate cancer. EAU guidelines 2024 . [Internet]. European Association of Urology; 2024. [cited 2024 May 27]. Available at: https://uroweb.org/guidelines/prostate-cancer.; Stamey TA, Yang N, Hay AR, McNeal JE, Freiha FS and Redwine E. Prostate-specific antigen as a serum marker for adenocarcinoma of the prostate. N Engl J Med 1987; 317: 909–16. doi: 10.1056/NEJM198710083171501. (PMID: 10.1056/NEJM198710083171501); Sokoll LJ, Chan DW, Mikolajczyk SD, Rittenhouse HG, Evans CL, Linton HJ, et al. Proenzyme psa for the early detection of prostate cancer in the 2.5–4.0 ng/ml total psa range: preliminary analysis. Urology 2003; 61 : 274–6. doi: 10.1016/s0090-4295(02)02398-1. (PMID: 10.1016/s0090-4295(02)02398-1); Hedelin H, Johansson N and Stroberg P. Relationship between benign prostatic hyperplasia and lower urinary tract symptoms and correlation between prostate volume and serum prostate-specific antigen in clinical routine. Scand J Urol Nephrol 2005; 39: 154–9. doi: 10.1080/00365590510007685. (PMID: 10.1080/00365590510007685); Chambo RC, Tsuji FH, de Oliveira Lima F, Yamamoto HA and de Jesus CM. What is the ideal core number for ultrasound-guided prostate biopsy? Korean J Urol 2014; 55: 725–31. doi: 10.4111/kju.2014.55.11.725. (PMID: 10.4111/kju.2014.55.11.725); Walz J, Graefen M, Chun FK, Erbersdobler A, Haese A, Steuber T, et al. High incidence of prostate cancer detected by saturation biopsy after previous negative biopsy series. Eur Urol 2006; 50 : 498–505. doi: 10.1016/j.eururo.2006.03.026. (PMID: 10.1016/j.eururo.2006.03.026); Bell KJ, Del Mar C, Wright G, Dickinson J and Glasziou P. Prevalence of incidental prostate cancer: a systematic review of autopsy studies. Int J Cancer 2015; 137: 1749–57. doi: 10.1002/ijc.29538. (PMID: 10.1002/ijc.29538); Jansen FH, van Schaik RH, Kurstjens J, Horninger W, Klocker H, Bektic J, et al. Prostate-specific antigen (PSA) isoform p2PSA in combination with total PSA and free PSA improves diagnostic accuracy in prostate cancer detection. Eur Urol 2010; 57: 921–7. doi: 10.1016/j.eururo.2010.02.003. (PMID: 10.1016/j.eururo.2010.02.003); Loeb S and Catalona WJ. The Prostate Health Index: a new test for the detection of prostate cancer. Ther Adv Urol 2014; 6: 74–7. doi: 10.1177/1756287213513488. (PMID: 10.1177/1756287213513488); Deras IL, Aubin SM, Blase A, Day JR, Koo S, Partin AW, et al. PCA3: a molecular urine assay for predicting prostate biopsy outcome. J Urol 2008; 179: 1587–92. doi: 10.1016/j.juro.2007.11.038. (PMID: 10.1016/j.juro.2007.11.038); Van Neste L, Hendriks RJ, Dijkstra S, Trooskens G, Cornel EB, Jannink SA, et al. Detection of high-grade prostate cancer using a urinary molecular biomarker-based risk score. Eur Urol 2016; 70: 740–8. doi: 10.1016/j.eururo.2016.04.012. (PMID: 10.1016/j.eururo.2016.04.012); Futterer JJ. Multiparametric MRI in the detection of clinically significant prostate cancer. Korean J Radiol 2017; 18: 597–606. doi: 10.3348/kjr.2017.18.4.597. (PMID: 10.3348/kjr.2017.18.4.597); Drost FH, Osses DF, Nieboer D, Steyerberg EW, Bangma CH, Roobol MJ, et al. Prostate MRI, with or without MRI-targeted biopsy, and systematic biopsy for detecting prostate cancer. Cochrane Database Syst Rev 2019; 4: CD012663. doi: 10.1002/14651858.CD012663.pub2. (PMID: 10.1002/14651858.CD012663.pub2); Bratan F, Niaf E, Melodelima C, Chesnais AL, Souchon R, Mege-Lechevallier F, et al. Influence of imaging and histological factors on prostate cancer detection and localisation on multiparametric MRI: a prospective study. Eur Radiol 2013; 23: 2019–29. doi: 10.1007/s00330-013-2795-0. (PMID: 10.1007/s00330-013-2795-0); Futterer JJ, Briganti A, De Visschere P, Emberton M, Giannarini G, Kirkham A, et al. Can clinically significant prostate cancer be detected with multiparametric magnetic resonance imaging? A systematic review of the literature. Eur Urol 2015; 68: 1045–53. doi: 10.1016/j.eururo.2015.01.013. (PMID: 10.1016/j.eururo.2015.01.013); Weinreb JC, Barentsz JO, Choyke PL, Cornud F, Haider MA, Macura KJ, et al. PI-RADS Prostate Imaging - Reporting and Data System: 2015, Version 2. Eur Urol 2016; 69: 16–40. doi: 10.1016/j.eururo.2015.08.052. (PMID: 10.1016/j.eururo.2015.08.052); Xu G, Li JH, Xiang LH, Yang B, Chen YC, Sun YK, et al. Transrectal ultrasound examination of prostate cancer guided by fusion imaging of multiparametric MRI and TRUS: avoiding unnecessary mpMRI-guided targeted biopsy. Asian J Androl 2023; 25: 410–5. doi: 10.4103/aja202276. (PMID: 10.4103/aja202276); Littrup PJ and Bailey SE. Prostate cancer: the role of transrectal ultrasound and its impact on cancer detection and management. Radiol Clin North Am 2000; 38: 87–113. doi: 10.1016/s0033-8389(05)70151-2. (PMID: 10.1016/s0033-8389(05)70151-2); Wegelin O, Exterkate L, van der Leest M, Kummer JA, Vreuls W, de Bruin PC, et al. The FUTURE Trial: a multicenter randomised controlled trial on target biopsy techniques based on magnetic resonance imaging in the diagnosis of prostate cancer in patients with prior negative biopsies. Eur Urol 2019; 75: 582–90. doi: 10.1016/j.eururo.2018.11.040. (PMID: 10.1016/j.eururo.2018.11.040); Simmons LAM, Kanthabalan A, Arya M, Briggs T, Barratt D, Charman SC, et al. Accuracy of transperineal targeted prostate biopsies, visual estimation and image fusion in men needing repeat biopsy in the PICTURE Trial. J Urol 2018; 200: 1227–34. doi: 10.1016/j.juro.2018.07.001. (PMID: 10.1016/j.juro.2018.07.001); Wegelin O, van Melick HHE, Hooft L, Bosch J, Reitsma HB, Barentsz JO, et al. Comparing three different techniques for magnetic resonance imaging-targeted prostate biopsies: a systematic review of in-bore versus magnetic resonance imaging-transrectal ultrasound fusion versus cognitive registration. Is there a preferred technique? Eur Urol 2017; 71: 517–31. doi: 10.1016/j.eururo.2016.07.041. (PMID: 10.1016/j.eururo.2016.07.041); Watts KL, Frechette L, Muller B, Ilinksy D, Kovac E, Sankin A, et al. Systematic review and meta-analysis comparing cognitive vs. image-guided fusion prostate biopsy for the detection of prostate cancer. Urol Oncol 2020; 38: 734 e19–e25. doi: 10.1016/j.urolonc.2020.03.020. (PMID: 10.1016/j.urolonc.2020.03.020); Smrkolj T. [Transrectal ultrasound and needle biopsy of the prostate]. [Slovenian]. Zdrav Vestn 2015; 84: 834–42. doi: 10.6016/ZdravVestn.1299. (PMID: 10.6016/ZdravVestn.1299); Ortner G, Mavridis C, Fritz V, Schachtner J, Mamoulakis C, Nagele U, et al. The added value of MRI-based targeted biopsy in biopsy-naive patients: a propensity-score matched comparison. J Clin Med 2024; 13: 1. doi: 10.3390/jcm13051355. (PMID: 10.3390/jcm13051355); Connor MJ, Miah S, Jayadevan R, Khoo CC, Eldred-Evans D, Shah T, et al. Value of systematic sampling in an mpMRI targeted prostate biopsy strategy. Transl Androl Urol 2020; 9: 1501–9. doi: 10.21037/tau.2019.07.16. (PMID: 10.21037/tau.2019.07.16); Malewski W, Milecki T, Szemplinski S, Tayara O, Kuncman L, Kryst P, et al. Prostate biopsy in the case of PIRADS 5 - is systematic biopsy mandatory? J Clin Med 2023; 12: 5612. doi: 10.3390/jcm12175612. (PMID: 10.3390/jcm12175612); Kasabwala K, Patel N, Cricco-Lizza E, Shimpi AA, Weng S, Buchmann RM, et al. The learning curve for magnetic resonance imaging/ultrasound fusion-guided prostate biopsy. Eur Urol Oncol 2019; 2: 135–40. doi: 10.1016/j.euo.2018.07.005. (PMID: 10.1016/j.euo.2018.07.005); Xu L, Ye NY, Lee A, Chopra J, Naslund M, Wong-You-Cheong J, et al. Learning curve for magnetic resonance imaging/ultrasound fusion prostate biopsy in detecting prostate cancer using cumulative sum analysis. Curr Urol 2023; 17: 159–64. doi: 10.1097/CU9.0000000000000116. (PMID: 10.1097/CU9.0000000000000116); Mager R, Brandt MP, Borgmann H, Gust KM, Haferkamp A and Kurosch M. From novice to expert: analyzing the learning curve for MRI-transrectal ultrasonography fusion-guided transrectal prostate biopsy. Int Urol Nephrol 2017; 49: 1537–44. doi: 10.1007/s11255-017-1642-7. (PMID: 10.1007/s11255-017-1642-7); Turchi B, Lombardo R, Franco A, Tema G, Nacchia A, Cicione A, et al. Residents and consultants have equal outcomes when performing transrectal fusion biopsies: a randomized clinical trial. Curr Oncol 2024; 31: 747–58. doi: 10.3390/curroncol31020055. (PMID: 10.3390/curroncol31020055); Rodriguez-Cabello MA, Mendez-Rubio S, Sanz-Miguelanez JL, Moraga-Sanz A, Aullo-Gonzalez C and Platas-Sancho A. Prevalence and grade of malignancy differences with respect to the area of involvement in multiparametric resonance imaging of the prostate in the diagnosis of prostate cancer using the PI-RADS version 2 classification. World J Urol 2023; 41: 2155–63. doi: 10.1007/s00345-023-04466-0. (PMID: 10.1007/s00345-023-04466-0); Schlenker B, Apfelbeck M, Armbruster M, Chaloupka M, Stief CG and Clevert DA. Comparison of PIRADS 3 lesions with histopathological findings after MRI-fusion targeted biopsy of the prostate in a real world-setting. Clin Hemorheol Microcirc 2019; 71: 165–70. doi: 10.3233/CH-189407. (PMID: 10.3233/CH-189407); Nicola R and Bittencourt LK. PIRADS 3 lesions: a critical review and discussion of how to improve management. Abdom Radiol (NY) 2023; 48: 2401–5. doi: 10.1007/s00261-023-03929-7. (PMID: 10.1007/s00261-023-03929-7); Patel HD, Halgrimson WR, Sweigert SE, Shea SM, Turk TMT, Quek ML, et al. Variability in prostate cancer detection among radiologists and urologists using MRI fusion biopsy. BJUI Compass 2024; 5: 304–12. doi: 10.1002/bco2.294. (PMID: 10.1002/bco2.294); Berry B, Parry MG, Sujenthiran A, Nossiter J, Cowling TE, Aggarwal A, et al. Comparison of complications after transrectal and transperineal prostate biopsy: a national population-based study. BJU Int 2020; 126: 97–103. doi: 10.1111/bju.15039. (PMID: 10.1111/bju.15039); Mian BM, Feustel PJ, Aziz A, Kaufman RP, Jr., Bernstein A, Avulova S, et al. Complications following transrectal and transperineal prostate biopsy: results of the ProBE-PC Randomized Clinical Trial. J Urol 2024; 211: 205–13. doi: 10.1097/JU.0000000000003788. (PMID: 10.1097/JU.0000000000003788) |
| Contributed Indexing: | Keywords: complications; learning curve; prostate cancer; targeted prostate biopsy |
| Entry Date(s): | Date Created: 20241128 Date Completed: 20241128 Latest Revision: 20250603 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC11604262 |
| DOI: | 10.2478/raon-2024-0060 |
| PMID: | 39608006 |
| Database: | MEDLINE |
Journal Article