To evaluate the accuracy in histologic grading of MRI/US image fusion biopsy by comparing histopathology between systematic biopsies (SB), targeted biopsies (TB) and the combination of both (SB + TB) with the final histopathologic outcomes of radical prostatectomy specimens.
Retrospective, multicentric study of 443 patients who underwent SB and TB using MRI/US fusion technique (Urostation® and Trinity®) prior to radical prostatectomy between 2010 and 2017. Cochran's Q test and McNemar test were conducted as a post hoc test. Uni-multivariable analyses were performed on several clinic-pathological variables to analyze factors predicting histopathological concordance for targeted biopsies.
Concordance in ISUP (International Society of Urological Pathology) grade between SB, TB and SB + TB with final histopathology was 49.4%, 51.2%, and 63.2% for overall prostate cancer and 41.2%, 48.3%, and 56.7% for significant prostate cancer (ISUP grade ≥ 2), respectively. Significant difference in terms of concordance, downgrading and upgrading was found between SB and TB (ISUP grade ≥ 2 only), SB and SB + TB, TB and SB + TB (overall ISUP grade and ISUP grade ≥ 2) (p < 0.001). Total number of cores and previous biopsies were significant independent predictive factors for concordance with TB technique.
In this retrospective study, combination of SB and TB significantly increased concordance with final histopathology despite a limited additional number of cores needed.
World journal of urology. 2019 Jan 16 [Epub ahead of print]
R Diamand, M Oderda, W Al Hajj Obeid, S Albisinni, R Van Velthoven, G Fasolis, G Simone, M Ferriero, J-B Roche, T Piechaud, A Pastore, A Carbone, G Fiard, J-L Descotes, G Marra, P Gontero, E Altobelli, R Papalia, P Kumar, D Eldred-Evans, A Giacobbe, G Muto, V Lacetera, V Beatrici, T Roumeguere, A Peltier
Department of Urology, Jules Bordet Institute, Université Libre de Bruxelles, Boulevard de Waterloo 121, 1000, Brussels, Belgium. ., Department of Urology, San Lazzaro Hospital, Alba, Italy., Department of Urology, Jules Bordet Institute, Université Libre de Bruxelles, Boulevard de Waterloo 121, 1000, Brussels, Belgium., Department of Urology, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium., Department of Urology, Regina Elena National Cancer Institute, Rome, Italy., Department of Urology, Saint Augustin Clinic, Bordeaux, France., Department of Medico-Surgical Sciences and Biotechnologies, Urology Unit, Sapienza University of Rome, Latina, Italy., Department of Urology, Grenoble University Hospital, Grenoble, France., Department of Surgical Sciences, Urology Unit, University of Turin, Turin, Italy., Department of Urology, Campus Bio-medico University, Rome, Italy., Department of Urology, Royal Marsden Hospital, London, UK., Department of Urology, Charing Cross Hospital, London, UK., Department of Urology, Humanitas Gradenigo Hospital, Turin, Italy., Department of Urology, Azienda Ospedaliera Ospedali Riuniti Marche Nord Hospital, Pesaro Fano, Italy.