AUA 2017: Utility of Multi-Parametric MRI/Ultrasound Fusion: Cognitive not Inferior to Targeted Software-Based Prostate Biopsies

Boston, MA ( Dr. Chu presented on the topic of using cognitive biopsies with multi-parametric MRI rather than software fused based platforms. Their objective was to determine if cognitive or fusion biopsies provided better sensitivities for prostate cancer detection. This study found that for patients undergoing MRI-ultrasound fusion biopsy for elevated PSA, abnormal DRE, active surveillance or a prior negative biopsy with a persistently elevated PSA using the UroNav biopsy tracking system was no better than cognitive biopsies. All patients had pre-biopsy multi-parametric MRI with PI-RADS v2 grading. The biopsy consisted of first a cognitive biopsy, second a targeted biopsy and then a random 12 core biopsy. They found the cognitive biopsy to have a higher sensitivity of 69% (95%CI: 50%-88%) compared to 46% (95%CI: 26%-67%) for the targeted biopsy. They reported the targeted approach missed eight cancers while the cognitive approach missed two cancers.

This topic is important for dissemination of the technology to none tertiary care centers. One limitation may be for small lesions artifact from the cognitive biopsy may have limited the fusion biopsy detection. However, this study may be able to make an impact for community urology and advance the biopsies offered to patients. Dissemination of the technology will also improve patient access and decrease biopsy waiting times. Using data from this study highlights the importance of getting an MRI itself rather than the computer platform which provides the targets for the biopsies.

Presented by Dr. William Chu, MD from City of Hope, Durate, CA

Written By: Janet Baack Kukreja (@janetkukreja), MD, MPH, Urologic Oncology Fellow, Department of Urology, UT MD Anderson Cancer Center, Houston, TX, Ashish M. Kamat, MD, MBBS, FACS, Wayne B. Duddlesten Professor, Department of Urology, UT MD Anderson Cancer Center, Houston TX

at the 2017 AUA Annual Meeting - May 12 - 16, 2017 – Boston, Massachusetts, USA