FREE DAILY AND WEEKLY NEWSLETTERS OFFERED BY CONTENT OF INTEREST
Did you find this article relevant? Subscribe to UroToday-GUOncToday!
The fields of GU Oncology and Urology are advancing rapidly including new treatments, enrolling clinical trials, screening and surveillance recommendations along with updated guidelines. Join us as one of our subscribers who rely on UroToday as their must-read source for the latest news and data on drugs. Sign up today for blogs, video conversations, conference highlights and abstracts from peer-review publications by disease and condition delivered to your inbox and read on the go.
The results of the study found that disease upgrading based on SBx over FBx occurred in 135/1003 (13.5%) patients. The majority of upgrading was due to FBx avoiding detection of Gleason 6 cancers, while in the remaining 62/135 (45.9%), results from SBx revealed intermediate or high-risk disease while FBx showed benign or low-risk disease. Multivariate logistic regression analysis showed that lower PSA (p<0.001), higher mRI prostate volume (p<0.001), and lower number of target cores (p=0.001) were predictors of upgrading by SBx..
The researchers proposed 4 potential mechanisms for failure of FBx in identifying CS disease: mpMRI reader oversight, mpMRI invisible cancers, inaccurate sampling of lesion during FBx due to registration and/or mechanical error, and intra-lesion Gleason heterogeneity. The main mechanisms for under-grading by FBx included mpMRI reader oversight, presence of MR invisible cancer, FBx technique error, and intra-lesion Gleason heterogeneity. In conclusion, MRI and FBx remain highly accurate in detecting the vast majority of PCa, as only 62/1003 (6.2%) cases in the study were upgraded to CS disease by SBx. Additional studies are needed to help elucidate the mechanisms of FBx failure, and identify patients that benefit from SBx in addition to FBx.
Authors: Akhil Muthigi*, BS1 ; Arvin K. George*, MD2 ; Abhinav Sidana, MD1 ; Michael Kongnyuy, MS1 ; Richard Simon, DSc3 ; Vanessa Moreno, MD4 ; Maria J. Merino, MD4 ; Peter L. Choyke, MD5 ; Baris Turkbey, MD5 ; Bradford J. Wood, MD6 ; Peter A. Pinto, MD1
Affiliations: 1Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland 2Department of Urology, University of Michigan, Ann Arbor, Michigan. 3Biometric Research Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD 4Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, Maryland 5 Molecular Imaging Program, National Cancer Institute, National Institutes of Health, Bethesda, Maryland 6Center for Interventional Oncology, National Cancer Institute & Clinical Center, National Institutes of Health, Bethesda, Maryland
Read the Abstract
1. George, A. K., Turkbey, B., Valayil, S. G. et al.: A urologist's perspective on prostate cancer imaging: past, present, and future. Abdom Radiol (NY), 2016
2. Valerio, M., Donaldson, I., Emberton, M. et al.: Detection of Clinically Significant Prostate Cancer Using Magnetic Resonance Imaging-Ultrasound Fusion Targeted Biopsy: A Systematic Review. Eur Urol, 68: 8, 2015 7.
3. Rastinehad, A. R., Turkbey, B., Salami, S. S. et al.: Improving detection of clinically significant prostate cancer: magnetic resonance imaging/transrectal ultrasound fusion guided prostate biopsy. J Urol, 191: 1749, 2014
4. Rastinehad, A. R., Abboud, S. F., George, A. K. et al.: Reproducibility of Multiparametric MRI and Fusion-Guided Prostate Biopsy: Multi-Institutional External Validation by a Propensity Score Matched Cohort. J Urol, 2016