To evaluate the cancer detection rates of reduced-core biopsy schemes in patients with unilateral mpMRI-visible intraprostatic lesions and to analyze the contribution of systematic biopsy cores in clinically significant prostate cancer (csPCa) detection.
212 patients with mpMRI-visible unilateral intraprostatic lesions undergoing MRI/TRUS fusion-guided targeted biopsy (TBx) and systematic biopsy (SBx) were included. Cancer detection rates of TBx + SBx, as determined by highest Gleason Grade Group (GG), were compared to 3 reduced-core biopsy schemes: TBx alone, TBx + ipsilateral systematic biopsy (IBx; MRI-positive hemigland), and TBx + contralateral systematic biopsy (CBx; MRI-negative hemigland). Patient-level and biopsy core-level data were analyzed using descriptive statistics with confidence intervals. Univariable and multivariable logistic regression analysis was conducted to identify predictors of csPCa (≥ GG2) detected in MRI-negative hemiglands at p < 0.05.
Overall, 43.4% (92/212) of patients had csPCa and 66.0% (140/212) of patients had any PCa detected by TBx + SBx. Of patients with csPCa, 81.5% had exclusively ipsilateral involvement (MRI-positive), 7.6% had only contralateral involvement (MRI-negative), and 10.9% had bilateral involvement. The csPCa detection rates of reduced-core biopsy schemes were 35.4% (75/212), 40.1% (85/212), and 39.6% (84/212) for TBx alone, TBx + IBx, and TBx + CBx, respectively, with detection sensitivities of 81.5%, 92.4%, and 91.3% compared to TBx + SBx.
Reduced-core prostate biopsy strategies confined to the ipsilateral hemigland underestimate csPCa burden by at least 8% in patients with unilateral mpMRI-visible intraprostatic lesions. The combined TBx + SBx strategy maximizes csPCa detection.
Abdominal radiology (New York). 2022 Dec 17 [Epub ahead of print]
Tim E Phelps, Enis C Yilmaz, Stephanie A Harmon, Mason J Belue, Joanna H Shih, Charisse Garcia, Lindsey A Hazen, Antoun Toubaji, Maria J Merino, Sandeep Gurram, Peter L Choyke, Bradford J Wood, Peter A Pinto, Baris Turkbey
Molecular Imaging Branch, National Cancer Institute, NIH, Bethesda, MD, USA., Biometric Research Program, National Cancer Institute, NIH, Rockville, MD, USA., Center for Interventional Oncology, National Cancer Institute, NIH, Bethesda, MD, USA., Laboratory of Pathology, National Cancer Institute, NIH, Bethesda, MD, USA., Urologic Oncology Branch, National Cancer Institute, NIH, Bethesda, MD, USA., Molecular Imaging Branch, National Cancer Institute, NIH, Bethesda, MD, USA. .