Due to the discomfort and incidence of complications increases with the increasing number of biopsy cores, the protocol of prostate biopsy has been promoted from systematic biopsy (SB) to targeted biopsy (TB) in many studies. However, the optimal prostate sampling scheme to balance the incidence of biopsy complications and accuracy of biopsy remains controversial. Our objective is to explore an optimal prostate cancer (PCa) sampling scheme with fewer SB cores.
Patients with at least one lesion of Prostate Imaging Reporting and Data System ≥3 were prospectively enrolled. TB and SB were performed for each patient as reference. The hypothetical biopsy sampling schemes were TB only, SB only, and TB followed by SB of the nontargeted sector (TB+nSB). The PCa and clinically significant PCa (csPCa) detection rates and cores of the three hypothetical biopsy schemes were compared with TB+SB.
Among 165 patients, 107 (64.8%) were diagnosed with PCa and 91 (55.2%) with csPCa via TB+SB. There were 54 (50.5%) and 42 (46.2%) magnetic resonance imaging (MRI) true negative cases and 53 (49.5%) and 49 (53.8%) false negative cases of nontargeted sectors among PCa and csPCa patients, respectively. The maximal cancer proportion in positive biopsy cases differed significantly between the true and false groups of these cohorts. There was no difference between TB+nSB and TB+SB for PCa or csPCa detection.
The optimal sampling scheme TB+nSB with fewer SB cores showed same PCa and csPCa detection rates as that of standard TB+SB with MRI/ultrasound fusion biopsy.
Prostate cancer and prostatic diseases. 2020 Jul 27 [Epub ahead of print]
Hua Liu, Mingjian Ruan, He Wang, Hao Wang, Xueying Li, Gang Song
The Department of Urology, Peking University First Hospital, 100034, Beijing, China., The Department of Radiology, Peking University First Hospital, 100034, Beijing, China., The Department of Statistics, Peking University First Hospital, 100034, Beijing, China., The Department of Urology, Peking University First Hospital, 100034, Beijing, China. .