How Many Targeted Biopsy Cores are Needed for Clinically Significant Prostate Cancer Detection during Transperineal Magnetic Resonance Imaging Ultrasound Fusion Biopsy?

No AccessJournal of UrologyAdult Urology1 Dec 2020How Many Targeted Biopsy Cores are Needed for Clinically Significant Prostate Cancer Detection during Transperineal Magnetic Resonance Imaging Ultrasound Fusion Biopsy? Gang Song, Mingjian Ruan, He Wang, Yu Fan, Qun He, Zhiyong Lin, Xueying Li, Peng Li, Xiaoying Wang, Zhisong He, and Liqun Zhou Gang SongGang Song *Correspondence: Department of Urology, Peking University First Hospital, The Institute of Urology, Peking University, The National Urological Cancer Center of China, No. 8 Xishiku St., Xicheng District, Beijing 100034China telephone: +86-10-83575101; FAX: +86-10-66551726; E-mail Address: [email protected] Department of Urology, Peking University First Hospital, Beijing, China Institute of Urology, Peking University, Beijing, China National Urological Cancer Center of China, Beijing, China , Mingjian RuanMingjian Ruan Department of Urology, Peking University First Hospital, Beijing, China Institute of Urology, Peking University, Beijing, China National Urological Cancer Center of China, Beijing, China , He WangHe Wang Department of Radiology, Peking University First Hospital, Beijing, China , Yu FanYu Fan Department of Urology, Peking University First Hospital, Beijing, China Institute of Urology, Peking University, Beijing, China National Urological Cancer Center of China, Beijing, China , Qun HeQun He Department of Urology, Peking University First Hospital, Beijing, China Institute of Urology, Peking University, Beijing, China National Urological Cancer Center of China, Beijing, China , Zhiyong LinZhiyong Lin Department of Radiology, Peking University First Hospital, Beijing, China , Xueying LiXueying Li Department of Statistics, Peking University First Hospital, Beijing, China , Peng LiPeng Li Department of Ultrasound, Peking University First Hospital, Beijing, China , Xiaoying WangXiaoying Wang Department of Radiology, Peking University First Hospital, Beijing, China , Zhisong HeZhisong He Department of Urology, Peking University First Hospital, Beijing, China Institute of Urology, Peking University, Beijing, China National Urological Cancer Center of China, Beijing, China , and Liqun ZhouLiqun Zhou Department of Urology, Peking University First Hospital, Beijing, China Institute of Urology, Peking University, Beijing, China National Urological Cancer Center of China, Beijing, China View All Author Informationhttps://doi.org/10.1097/JU.0000000000001302AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: In this study we determined the optimal number of transperineal magnetic resonance imaging ultrasound fusion targeted biopsy cores per lesion needed for the detection of clinically significant prostate cancer. Materials and Methods: A total of 101 patients with at least 1 lesion with a PI-RADS® (Prostate Imaging Reporting and Data System) score of 3 or greater were recruited prospectively. At least 4 transperineal magnetic resonance imaging ultrasound fusion targeted biopsy cores per lesion were performed, followed by systematic biopsy. The Kappa test was used to evaluate the consistency of the clinically significant prostate cancer detection rate between different targeted biopsy cores and 4 or more cores, which was regarded as reference standard. Results: In the total cohort of 101 patients 49 (48.5%), 55 (54.5%) and 57 (56.4%) were diagnosed with clinically significant prostate cancer by systematic biopsy, targeted biopsy or targeted biopsy plus systematic biopsy, respectively. As for the total of 161 lesions, the clinically significant prostate cancer detection rate based on 1, 2, 3, or 4 or more targeted biopsy cores was made in 27.3%, 32.9%, 37.3% and 39.1%, respectively. Three cores showed great consistency with 4 or more cores in clinically significant prostate cancer detection rate (Kappa coefficient of 0.961, p <0.001) with a sensitivity of 95.2% (95% CI 85.8–98.8), and only missed 3 lesions harboring clinically significant prostate cancer. Similar results were obtained in cases with PI-RADS 3 or 4 or maximal diameter of less than 1.5 cm. Conclusions: Three targeted biopsies per lesion were suitable during transperineal magnetic resonance imaging ultrasound fusion biopsy, especially for lesions of PI-RADS 3 or 4, or small lesions (maximal diameter less than 1.5 cm), which may help to tailor targeted prostate biopsy procedures. References 1. : Magnetic resonance imaging-targeted biopsy may enhance the diagnostic accuracy of significant prostate cancer detection compared to standard transrectal ultrasound-guided biopsy: a systematic review and meta-analysis. Eur Urol 2015; 68: 438. 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Link, Google Scholar No direct or indirect commercial, personal, academic, political, religious or ethical incentive is associated with publishing this article. © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited BySmith J (2020) This Month in Adult UrologyJournal of Urology, VOL. 204, NO. 6, (1113-1114), Online publication date: 1-Dec-2020. Volume 204Issue 6December 2020Page: 1202-1208 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.Keywordsmagnetic resonance imagingimage-guided biopsyprostatic neoplasmsMetricsAuthor Information Gang Song Department of Urology, Peking University First Hospital, Beijing, China Institute of Urology, Peking University, Beijing, China National Urological Cancer Center of China, Beijing, China *Correspondence: Department of Urology, Peking University First Hospital, The Institute of Urology, Peking University, The National Urological Cancer Center of China, No. 8 Xishiku St., Xicheng District, Beijing 100034China telephone: +86-10-83575101; FAX: +86-10-66551726; E-mail Address: [email protected] Equal study contribution. More articles by this author Mingjian Ruan Department of Urology, Peking University First Hospital, Beijing, China Institute of Urology, Peking University, Beijing, China National Urological Cancer Center of China, Beijing, China Equal study contribution. More articles by this author He Wang Department of Radiology, Peking University First Hospital, Beijing, China More articles by this author Yu Fan Department of Urology, Peking University First Hospital, Beijing, China Institute of Urology, Peking University, Beijing, China National Urological Cancer Center of China, Beijing, China More articles by this author Qun He Department of Urology, Peking University First Hospital, Beijing, China Institute of Urology, Peking University, Beijing, China National Urological Cancer Center of China, Beijing, China More articles by this author Zhiyong Lin Department of Radiology, Peking University First Hospital, Beijing, China More articles by this author Xueying Li Department of Statistics, Peking University First Hospital, Beijing, China More articles by this author Peng Li Department of Ultrasound, Peking University First Hospital, Beijing, China More articles by this author Xiaoying Wang Department of Radiology, Peking University First Hospital, Beijing, China More articles by this author Zhisong He Department of Urology, Peking University First Hospital, Beijing, China Institute of Urology, Peking University, Beijing, China National Urological Cancer Center of China, Beijing, China More articles by this author Liqun Zhou Department of Urology, Peking University First Hospital, Beijing, China Institute of Urology, Peking University, Beijing, China National Urological Cancer Center of China, Beijing, China More articles by this author Expand All No direct or indirect commercial, personal, academic, political, religious or ethical incentive is associated with publishing this article. 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