| Autor: |
Lockhart, Kathleen, Martin, Jarad, White, Martin, Raman, Avi, Grant, Alexander, Chong, Peter |
| Zdroj: |
Journal of Clinical Urology; Sep2024, Vol. 17 Issue 5, p504-510, 7p |
| Abstrakt: |
Objective: This study assesses whether fusion or cognitive magnetic resonance imaging (MRI)-guided prostate targeted and systematic transperineal biopsies (TPB) increase detection of clinically significant prostate cancer (csPCa). Materials and Methods: A retrospective analysis was completed of patients (2018–2020) undergoing 3-Tesla multiparametric prostate MRI informing targeted (either cognitive or MIM software fusion approach) and systematic TPB. ISUP (International Society of Urological Pathology) grade group ⩾ 2 was considered csPCa. Results: A total of 355 cases from 4 urologists were included; 131 were fusion and 224 were cognitive MRI-guided biopsies. Of all csPCa found, 86.8% (n = 171) of cases were confirmed to be at the MRI-indicated location and 11.6% were found as part of active surveillance. In all, 45.0% of the fusion group were found to have csPCa, compared to 62.05% (n = 139) in the cognitive group (p = 0.002). csPCa detection rates varied between urologists (41% to 78%, p < 0.001), so a subgroup analysis was performed on Urologist A; 45.0% of fusion and 41.3% of cognitive biopsies had csPCa (p = 0.644). Multinomial logistic regression analysis showed that biopsy type, being on active surveillance, number of biopsy cores, iPSA (initial Prostate Specific Antigen) value or PIRADS (Prostate Imaging-Reporting and Data System) score made no significant difference in whether csPCa was found. Conclusion: Cognitive and fusion targeting had similar csPCa detection rates. Further prospective studies would be beneficial to validate these findings. Level of evidence: 2b (according to Oxford Centre for Evidence-Based Medicine) [ABSTRACT FROM AUTHOR] |
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