Optimizing Multiparametric Magnetic Resonance Imaging-Targeted Biopsy and Prostate Cancer Grading Accuracy - Beyond the Abstract

The most efficient biopsy method using a cohort of 753 patients diagnosed by multiparametric resonance imaging (MRI)-targeted and systematic biopsies (standard technique) and treated by radical prostatectomy was assessed. The ISUP grade group accuracy with final pathology was evaluated using several biopsy schemes and compared with standard technique.

Overall, ISUP grade group accuracy varied among biopsy methods with upgrading rates of 35%, 49%, 27%, and 24% for MRI-targeted, systematic, MRI-targeted, and ipsilateral systematic biopsies and standard methods, respectively (p < 0.001). A minimum of two positive MRI-targeted biopsies cores per index MRI lesion were required when testing MRI-targeted and ipsilateral systematic biopsies method to reach equivalent accuracy compared to standard method. Omitting contralateral systematic biopsies spared an average of 5.9 cores per patient. At multivariable analysis, only the number of positive MRI-targeted biopsy cores per index MRI lesion was predictive of upgrading.

In conclusion, MRI targeted and ipsilateral systematic biopsies allowed an accurate definition of ISUP grade group and appears to be an interesting alternative when compared with standard method, reducing the total number of biopsy cores needed.

Written by: Romain Diamand, Department of Urology, Jules Bordet Institute-Erasme Hospital, Universit√© Libre de Bruxelles, Brussels, Belgium

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