Evaluation of the Ginsburg Scheme: Where Is Significant Prostate Cancer Missed?

Ginsburg scheme biopsy strategy fusion biopsy image-guided biopsy [MeSH] prostatic neoplasms [MeSH]

Journal

Cancers
ISSN: 2072-6694
Titre abrégé: Cancers (Basel)
Pays: Switzerland
ID NLM: 101526829

Informations de publication

Date de publication:
20 May 2021
Historique:
received: 31 03 2021
revised: 11 05 2021
accepted: 17 05 2021
entrez: 2 6 2021
pubmed: 3 6 2021
medline: 3 6 2021
Statut: epublish

Résumé

Systematic biopsy (SB) according to the Ginsburg scheme (GBS) is widely used to complement MRI-targeted biopsy (MR-TB) for optimizing the diagnosis of clinically significant prostate cancer (sPCa). Knowledge of the GBS's blind sectors where sPCa is missed is crucial to improve biopsy strategies. We analyzed cancer detection rates in 1084 patients that underwent MR-TB and SB. Cancerous lesions that were missed or underestimated by GBS were re-localized onto a prostate map encompassing Ginsburg sectors and blind-sectors (anterior, central, basodorsal and basoventral). Logistic regression analysis (LRA) and prostatic configuration analysis were applied to identify predictors for missing sPCa with the GBS. GBS missed sPCa in 39 patients (39/1084, 3.6%). In 27 cases (27/39, 69.2%), sPCa was missed within a blind sector, with 17/39 lesions localized in the anterior region (43.6%). Neither LRA nor prostatic configuration analysis identified predictors for missing sPCa with the GBS. This is the first study to analyze the distribution of sPCa missed by the GBS. GBS misses sPCa in few men only, with the majority localized in the anterior region. Adding blind sectors to GBS defined a new sector map of the prostate suited for reporting histopathological biopsy results.

Sections du résumé

BACKGROUND BACKGROUND
Systematic biopsy (SB) according to the Ginsburg scheme (GBS) is widely used to complement MRI-targeted biopsy (MR-TB) for optimizing the diagnosis of clinically significant prostate cancer (sPCa). Knowledge of the GBS's blind sectors where sPCa is missed is crucial to improve biopsy strategies.
METHODS METHODS
We analyzed cancer detection rates in 1084 patients that underwent MR-TB and SB. Cancerous lesions that were missed or underestimated by GBS were re-localized onto a prostate map encompassing Ginsburg sectors and blind-sectors (anterior, central, basodorsal and basoventral). Logistic regression analysis (LRA) and prostatic configuration analysis were applied to identify predictors for missing sPCa with the GBS.
RESULTS RESULTS
GBS missed sPCa in 39 patients (39/1084, 3.6%). In 27 cases (27/39, 69.2%), sPCa was missed within a blind sector, with 17/39 lesions localized in the anterior region (43.6%). Neither LRA nor prostatic configuration analysis identified predictors for missing sPCa with the GBS.
CONCLUSIONS CONCLUSIONS
This is the first study to analyze the distribution of sPCa missed by the GBS. GBS misses sPCa in few men only, with the majority localized in the anterior region. Adding blind sectors to GBS defined a new sector map of the prostate suited for reporting histopathological biopsy results.

Identifiants

pubmed: 34065418
pii: cancers13102502
doi: 10.3390/cancers13102502
pmc: PMC8160743
pii:
doi:

Types de publication

Journal Article

Langues

eng

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Auteurs

August Sigle (A)

Department of Urology, Faculty of Medicine, University of Freiburg-Medical Centre, 79110 Freiburg, Germany.

Cordula A Jilg (CA)

Department of Urology, Faculty of Medicine, University of Freiburg-Medical Centre, 79110 Freiburg, Germany.

Timur H Kuru (TH)

Urologie am Ebertplatz, 50668 Cologne, Germany.

Nadine Binder (N)

Institute of Digitalization in Medicine, Faculty of Medicine and Medical Center, University of Freiburg, 79110 Freiburg, Germany.

Jakob Michaelis (J)

Department of Urology, Faculty of Medicine, University of Freiburg-Medical Centre, 79110 Freiburg, Germany.

Markus Grabbert (M)

Department of Urology, Faculty of Medicine, University of Freiburg-Medical Centre, 79110 Freiburg, Germany.

Wolfgang Schultze-Seemann (W)

Department of Urology, Faculty of Medicine, University of Freiburg-Medical Centre, 79110 Freiburg, Germany.

Arkadiusz Miernik (A)

Department of Urology, Faculty of Medicine, University of Freiburg-Medical Centre, 79110 Freiburg, Germany.

Christian Gratzke (C)

Department of Urology, Faculty of Medicine, University of Freiburg-Medical Centre, 79110 Freiburg, Germany.

Matthias Benndorf (M)

Department of Radiology, Faculty of Medicine, University of Freiburg-Medical Centre, 79110 Freiburg, Germany.

Rodrigo Suarez-Ibarrola (R)

Department of Urology, Faculty of Medicine, University of Freiburg-Medical Centre, 79110 Freiburg, Germany.

Classifications MeSH