Prospective comparison of cognitive and mpMR/US fusion biopsy for prostate cancer detection


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

Introduction. According to the recommendations of the European Association of Urology the presence of a suspicious lesion on MRI is an indication for both primary and secondary MR-targeted biopsies. At the same time, the Russian Society of Urologists recommends to perform mpMR/US fusion biopsy only in patients with a prior negative biopsy. In clinical practice, mpMR/US fusion and cognitive biopsies are the most frequently performed. However, when comparing them, contradictory data on detection of clinically significant prostate cancer is obtained. Objective to compare the detection rate of clinically significant prostate cancer performing cognitive and mpMR/US fusion biopsies. Materials and Methods. Inclusion criteria: PSA >2 ng/mL and/or a positive DRE, and/or a suspicious lesion on TRUS, and PI-RADSv2.1 lesion >3. At first, «unblinded» urologist performed a transperineal mpMR/ultrasound fusion and saturation biopsy. Then “blinded” urologist obtained transrectal cognitive biopsy Clinically significant cancer was defined as ISUP >2. Results. We enrolled 96 patients. Median age was 63 years, prostate volume - 47 cm3 and PSA - 6.82 ng/mL. MpMR/US fusion and cognitive biopsies were comparable in regard to the detection rate of clinically significant (32.3% vs 25.0%; p=0.264), clinically insignificant cancer (25.0% and 26.0%; p=0.869) and overall detection rate (57.3% and 51%; p=0.385). Both biopsies missed clinically significant cancer with equal frequency (5.2%; p=0.839). Histological efficacy also was comparable. The number of positive cores between mpMR/US fusion and cognitive biopsy was equal (34.1% and 31.1% respectively; p= 0.415). At the same time, no statistically significant difference was found with respect to maximum cancer core length (53.1% vs 47.7%, respectively; p=0.293). Conclusion. The results suggest that both cognitive and mpMR/US fusion biopsies are equally accurate diagnostic methods for clinically significant prostate cancer detection, thus their wider introduction into cIinicaI practice is necessary.

Full Text

Restricted Access

About the authors

V. S Petov

Sechenov University

Email: pettow@maii.ru
M.D., researcher Institute for UroIogy and Reproductive Health

A. K Bazarkin

Sechenov University

Email: ak.bazarkin@gmaii.com
Student

A. O Morozov

Sechenov University

Email: andrei.o.morozov@gmaii.com
M.D., PhD, senior researcher, Institute for UroIogy and Reproductive HeaIth

M. S Taratkin

Sechenov University

Email: marktaratkin@gmaii.com
researcher

T. M Ganzha

Sechenov University

Email: timurmed@hotmail.com
M.D.

S. P. Danilov

Sechenov University

Email: spdaniiov@gmaii.com
M.D.

Y. N Chernov

Sechenov University

Email: yarik.chernov@mail.ru
M.D.

D. V Chinenov

Sechenov University

M.D.

A. V Amosov

Sechenov University

Email: amosov-av@yandex.ru
M.D., professor

D. V Enikeev

Sechenov University

Email: dvenikeev@gmail.com
M.D., professor

G. E Krupinov

Sechenov University

Email: gekrupinov@mail.ru
M.D., professor

References

  1. Клинические рекомендации. Рак предстательной железы. 2021; Available from: https://oncology-association.ru/wp-content/uploads/2021/02/rpzh.pdf
  2. De Santis M., Fanti S., Gillessen S., Grummet J., Henry A., Lam T., et al. Prostate Cancer EAU-EANM-ESTRO-ESUR-SIOG Guidelines on. 2019
  3. Drost F.-J.H., Osses D.F., Nieboer D., Steyerberg E.W., Bangma C.H., Roobol M.J., et al. Prostate M.R.I., with or without MRI-targeted biopsy, and systematic biopsy for detecting prostate cancer. Cochrane Database Syst Rev. 2019 Apr;4(4), doi: 10.1002/14651858.CD012663.PUB2/
  4. Kasivisvanathan V., Rannikko A.S., Borghi M., Panebianco V., Mynderse L.A., Vaarala M.H., et al. MRI-Targeted or Standard Biopsy for Prostate -Cancer Diagnosis. N. Engl J. Med [Internet]. 2018 Mar 18 [cited 2022 Jan 8] ;378(19). Available from: https://pubmed.ncbi.nlm.nih.gov/29552975/, doi: 10.1056/NEJMOA1801993.
  5. Rouviere O., Puech P., Renard-Penna.R., Claudon M., Roy C., Mege-Lechevallier F., et al. Use of prostate systematic and targeted biopsy on the basis of multiparametric MRI in biopsy-naive patients (MRI-FIRST): a prospective, multicentre, paired diagnostic study. Lancet Oncol. 2019;20(1), doi: 10.1016/S1470-2045(18)30569-2.
  6. Zhang K., Zhang Z., Liu M., Zhu G., Roobol M.J. Comparison of clinically significant prostate cancer detection by MRI cognitive biopsy and in-bore MRI-targeted biopsy for naive biopsy patients. Transl Androl Urol [Internet]. 2020 Apr 1 [cited 2022 Jan 31];9(2):243. Available from: /pmc/articles/PMC7214969/. doi: 10.21037/tau.2020.02.20.
  7. Elkhoury F.F., Felker E.R., Kwan L., Sisk A.E., Delfin M., Natarajan S., et al. Comparison of Targeted vs Systematic Prostate Biopsy in Men Who Are Biopsy Naive: The Prospective Assessment of Image Registration in the Diagnosis of Prostate Cancer (PAIREDCAP) Study. JAMA Surg [Internet]. 2019 Sep 1 [cited 2022 Jan 31];154(9):811. Available from: /pmc/articles/PMC6563598/. doi: 10.1001/JAMASURG.2019.1734.
  8. Wegelin O., Exterkate L., van derLeest M., Kummer J.A., Vreuls W., de Bruin P.C., et al. The FUTURE Trial: A Multicenter Randomised Controlled Trial on Target Biopsy Techniques Based on Magnetic Resonance Imaging in the Diagnosis of Prostate Cancer in Patients with Prior Negative Biopsies. Eur Urol. 2019;75(4):582- 590. doi: 10.1016/j.eururo.2018.11.040.
  9. Panebianco V., Barchetti F., Manenti G., Aversa T., Catalano C., Simonetti G. MR imaging-guided prostate biopsy: technical features and preliminary results. Radiol Med [Internet]. 2015 Jun 22 [cited 2022 Jan 31];120(6):571- 578. Available from: https://pubmed.ncbi.nlm.nih.gov/25578784/. doi: 10.1007/S11547-014-0490-0.
  10. Yaxley A.J., Yaxley J.W., Thangasamy I.A., Ballard E., Pokorny M.R. Comparison between target magnetic resonance imaging (MRI) in-gantry and cognitively directed transperineal or transrectal-guided prostate biopsies for Prostate Imaging-Reporting and Data System (PI-RADS) 3-5 MRI lesions. BJU Int. 2017 Nov 1;120:43-50, doi: 10.1111/BJU.13971.
  11. Mottet N., van den Bergh R.C.N., Briers E., Van den Broeck T., Cumberbatch M.G., De Santis M., et al. EAU-EANM-ESTRO-ESUR-SIOG Guidelines on Prostate Cancer-2020 Update. Part 1: Screening, Diagnosis, and Local Treatment with Curative Intent. Vol. 79, European Urology. Eur Urol; 2021. 243-262. doi: 10.1016/j.eururo.2020.09.042.
  12. Wegelin O., Exterkate L., van der Leest M., Kelder J.C., Bosch J.L.H.R., Barentsz J.O., et al. Complications and Adverse Events of Three Magnetic Resonance Imaging-based Target Biopsy Techniques in the Diagnosis of Prostate Cancer Among Men with Prior Negative Biopsies: Results from the FUTURE Trial, a Multicentre Randomised Controlled Trial. Eur Urol Oncol. 2019 Nov;2(6):617-624. doi: 10.1016/j.euo.2019.08.007.
  13. Turkbey B., Rosenkrantz A.B., Haider M.A., Padhani A.R., Villeirs G. Macura K.J., et al. Prostate Imaging Reporting and Data System Version 2.1: 2019 Update of Prostate Imaging Reporting and Data System Version 2. Eur Urol [Internet]. 2019 Sep 1 [cited 2022 Jan 8];76(3):340-51. Available from: https://pubmed.ncbi.nlm.nih.gov/30898406/. Doi: 10.1016/J. EURURO.2019.02.033.
  14. Moore C.M., Kasivisvanathan V., Eggener S., Emberton M., FOtterer J.J., Gill I.S.,. et al. Standards of reporting for MRI-targeted biopsy studies (START) of the prostate: Recommendations from an international working group. Eur Urol. 2013. doi: 10.1016/j.eururo.2013.03.030.
  15. Stabile A., Dell’Oglio P., Gandaglia G., Fossati N., Brembilla G., Cristel G., et al. Not All Multiparametric Magnetic Resonance Imaging-targeted Biopsies Are Equal: The Impact of the Type of Approach and Operator Expertise on the Detection of Clinically Significant Prostate Cancer. Eur Urol Oncol [Internet]. 2018 Jun 1 [cited 2022 Feb 21];1(2):120-128. Available from: https://pubmed.ncbi.nlm.nih.gov/31100235/. Doi: 10.1016/J. EUO.2018.02.002.
  16. Kaufmann S., Russo G.I.,. Bamberg F., Lowe L., Morgia G., Nikolaou K., et al. Prostate cancer detection in patients with prior negative biopsy undergoing cognitive-, roboticor in-bore MRI target biopsy. World J. Urol. 2018;36(5):761-768. doi: 10.1016/J.EUO.2018.02.002.
  17. Oberlin D.T., Casalino D.D., Miller F.H., Matulewicz R.S., Perry K.T., Nadler R.B., et al. Diagnostic Value of Guided Biopsies: Fusion and Cognitive-registration Magnetic Resonance Imaging Versus Conventional Ultrasound Biopsy of the Prostate. Urology [Internet]. 2016 Jun 1 [cited 2022 Feb 18];92:75-79. Available from: https://pubmed.ncbi.nlm.nih.gov/26966043/. doi: 10.1016/J.UROLOGY.2016.02.041.
  18. Watts K.L., Frechette L., Muller B., Ilinksy D., Kovac E., Sankin A., et al. Systematic review and meta-analysis comparing cognitive vs. image-guided fusion prostate biopsy for the detection of prostate cancer. Urol Oncol [Internet]. 2020 Sep 1 [cited 2022 Feb 18];38(9):734.e19-734. e25. Available from: https://pubmed.ncbi.nlm.nih.gov/32321689/. doi: 10.1016/J.UROLONC.2020.03.02.
  19. Valerio M., McCartan N., Freeman A., Punwani S., Emberton M., Ahmed H.U. Visually directed vs. software-based targeted biopsy compared to transperineal template mapping biopsy in the detection of clinically significant prostate cancer. Urol Oncol [Internet]. 2015 Oct 1 [cited 2022 Feb 20];33(10):424.e9-424.e16. Available from: https://pubmed.ncbi.nlm. nih.gov/26195330/. doi: 10.1016/J.UROLONC.2015.06.012.
  20. Oderda M., Faletti R., Battisti G., Dalmasso E., Falcone M., Marra G., et al. Prostate Cancer Detection Rate with Koelis Fusion Biopsies versus Cognitive Biopsies: A Comparative Study. Urol Int. 2016 Aug 1;97(2):230-237. doi: 10.1159/000445524.
  21. Delongchamps N.B., Peyromaure M., Schull A., Beuvon.F., Bouazza N., Flam T., et al. Prebiopsy magnetic resonance imaging and prostate cancer detection: Comparison of random and targeted biopsies. J. Urol. 2013 Feb;189(2):493-499, doi: 10.1016/J.JURO.2012.08.195.
  22. Monda S.M., Vetter J.M., Andriole G.L., Fowler K.J., Shetty A.S., Weese J.R., et al. Cognitive Versus Software Fusion for MRI-targeted Biopsy: Experience Before and After Implementation of Fusion. Urology [Internet]. 2018 Sep 1 [cited 2022 Feb 20];119:115-20. Available from: https://pubmed.ncbi.nlm.nih.gov/29940232/. doi: 10.1016/J.UROLOGY.2018.06.011.
  23. Klingebiel M., Arsov C., Ullrich T., Quentin M., Al-Monajjed R., Mally D., et al. Reasons for missing clinically significant prostate cancer by targeted magnetic resonance imaging/ultrasound fusion-guided biopsy. Eur J. Radiol [Internet]. 2021 Apr 1 [cited 2022 Feb 20];137. Available from: https://pubmed.ncbi.nlm.nih.gov/33592552/. Doi: 10.1016/J. EJRAD.2021.109587.
  24. Xu G., Xiang L., Wu J., Shao H., Liu H., Ding S., et al. The accuracy of prostate lesion localization in cognitive fusion. Clin Hemorheol Microcirc. 2020;74(3):223-229. doi: 10.3233/CH-180423.
  25. Pepe P., Garufi A., Priolo G.D., Pennisi M. Multiparametric MRI/TRUS Fusion Prostate Biopsy: Advantages of a Transperineal Approach. Anticancer Res [Internet]. 2017 Jun 1 [cited 2022 Feb 1] ;37(6):3291- 3294. Available from: https://pubmed.ncbi.nlm.nih.gov/28551679/. doi: 10.21873/ANTICANRES.11695.
  26. Loy L.M., Lim G.H., Leow J.J., Lee C.H., Tan T.W., Tan C.H. A systematic review and meta-analysis of magnetic resonance imaging and ultrasound guided fusion biopsy of prostate for cancer detection-Comparing transrectal with transperineal approaches. Urol Oncol [Internet]. 2020 Aug 1 [cited 2022 Feb 1];38(8):650-660. Available from: https://pubmed.ncbi.nlm.nih.gov/32505458/. doi: 10.1016/J.UROLONC.2020.04.005.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies