Concordance of Gleason grading with three-dimensional ultrasound systematic biopsy and biopsy core pre-embedding

To determine the value of a three-dimensional (3D) greyscale transrectal ultrasound (TRUS)-guided prostate biopsy system and biopsy core pre-embedding method on concordance between Gleason scores of needle biopsies and radical prostatectomy (RP) specimens.

Retrospective analysis of prostate biopsies and subsequent RP for PCa in the Jeroen Bosch Hospital, the Netherlands, from 2007 to 2016. Two cohorts were analysed: conventional 2D TRUS-guided biopsies and RP (2007-2013, n = 266) versus 3D TRUS-guided biopsies with pre-embedding (2013-2016, n = 129). The impact of 3D TRUS-guidance with pre-embedding on Gleason score (GS) concordance between biopsy and RP was evaluated using the κ-coefficient. Predictors of biopsy GS 6 upgrading were assessed using logistic regression models.

Gleason concordance was comparable between the two cohorts with a κ = 0.44 for the 3D cohort, compared to κ = 0.42 for the 2D cohort. 3D TRUS-guidance with pre-embedding, did not significantly affect the risk of biopsy GS 6 upgrading in univariate and multivariate analysis.

3D TRUS-guidance with biopsy core pre-embedding did not improve Gleason concordance. Improved detection techniques are needed for recognition of low-grade disease upgrading.

World journal of urology. 2018 Feb 01 [Epub ahead of print]

Anouk A M A van der Aa, Christophe K Mannaerts, Hans van der Linden, Maudy Gayet, Bart Ph Schrier, Massimo Mischi, Harrie P Beerlage, Hessel Wijkstra

Department of Urology, Jeroen Bosch Hospital, Post office box 90153, 5200 ME, 's-Hertogenbosch, The Netherlands. ., Department of Urology, AMC University Hospital, Amsterdam, The Netherlands., Department of Pathology, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands., Department of Urology, Jeroen Bosch Hospital, Post office box 90153, 5200 ME, 's-Hertogenbosch, The Netherlands., Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.