Targeted vs systematic robot-assisted transperineal magnetic resonance imaging-transrectal ultrasonography fusion prostate biopsy.

Autor: Mischinger, Johannes, Kaufmann, Sascha, Russo, Giorgio I., Harland, Niklas, Rausch, Steffen, Amend, Bastian, Scharpf, Marcus, Loewe, Lorenz, Todenhoefer, Tilman, Notohamiprodjo, Mike, Nikolaou, Konstantin, Stenzl, Arnulf, Bedke, Jens, Kruck, Stephan
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Zdroj: BJU International; May2018, Vol. 121 Issue 5, p791-798, 8p
Abstrakt: Objective To evaluate the performance of transperineal robot-assisted (RA) targeted (TB) and systematic (SB) prostate biopsy in primary and repeat biopsy settings. Patients and Methods Patients underwent RA biopsy between 2014 and 2016. Before RA-TB, multiparametric magnetic resonance imaging (mpMRI) was performed. Prostate lesions were scored (Prostate Imaging, Reporting and Data System, version 2) and used for RA-TB planning. In addition, RA-SB was performed. Available, whole-gland pathology was analysed. Results In all, 130 patients were biopsy naive and 72 had had a previous negative transrectal ultrasonography-guided biopsy. In total, 202 patients had suspicious mpMRI lesions. Clinically significant prostate cancer was found in 85% of all prostate cancer cases (n = 123). Total and clinically significant prostate cancer detection rates for RA-TB vs RA-SB were not significantly different at 77% vs 84% and 80% vs 82%, respectively. RA-TB demonstrated a better sampling performance compared to RA-SB (26.4% vs 13.9%; P < 0.001). Conclusion Transperineal RA-TB and -SB showed similar clinically significant prostate cancer detection rates in primary and repeat biopsy settings. However, RA-TB offered a 50% reduction in biopsy cores. Omitting RA-SB is associated with a significant risk of missing clinically significant prostate cancer. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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