Which protocol for prostate biopsies in patients with a positive MRI? Interest of systematic biopsies by sectors.
Journal
Prostate cancer and prostatic diseases
ISSN: 1476-5608
Titre abrégé: Prostate Cancer Prostatic Dis
Pays: England
ID NLM: 9815755
Informations de publication
Date de publication:
19 Dec 2023
19 Dec 2023
Historique:
received:
27
07
2023
accepted:
24
11
2023
revised:
16
11
2023
medline:
20
12
2023
pubmed:
20
12
2023
entrez:
19
12
2023
Statut:
aheadofprint
Résumé
Current prostate biopsy (PBx) protocol for prostate cancer (PCa) diagnosis is to perform systematic biopsies (SBx) combined with targeted biopsies (TBx) in case of positive MRI (i.e. PI-RADS ≥ 3). To assess the utility of performing SBx in combination with TBx, we determined the added value of SBx brought to the diagnosis of PCa according to their sextant location and MRI target characteristics. In our local prospectively collected database, we conducted a single-center retrospective study including all patients with a suspicion of PCa, who underwent transrectal ultrasound-guided (TRUS) prostate biopsies (PBx) with a prior MRI and a single lesion classified as PI-RADS ≥ 3. We have characterized the SBx according to their location on MRI: same sextant (S-SBx), adjacent sextant (A-SBx), ipsilateral side (I-SBx) and contralateral side (C-SBx). The added value of SBx and TBx was defined as any upgrading to significant PCa (csPCa) (ISUP ≥2). 371 patients were included in the study. The added value of SBx was 10% overall. Regarding the lesion location and the SBx sextant, the added value of SBx was: 5.1% for S-SBx, 5.4% for A-SBx, 4.9% for I-SBx and 1.9% for C-SBx. The overall added value of SBx was 6.8% for PI-RADS 3 lesions, 14% for PI-RADS 4 lesions and 6.7% for PI-RADS 5 lesions (p = 0.063). The added value of SBx for contralateral side was 1.9% (2/103), 3.1% (5/163) and 0% (0/105) for PI-RADS 3, PI-RADS 4 and PI-RADS 5 lesions, respectively (p = 0,4). The added value of SBx was lower when the number of TBx was higher (OR 0.57; CI 95% 0.37-0.85; p = 0.007). Our results suggest that the utility of performing SBx in the contralateral lobe toward the MRI lesion was very low, supporting that they might be avoided.
Sections du résumé
BACKGROUND
BACKGROUND
Current prostate biopsy (PBx) protocol for prostate cancer (PCa) diagnosis is to perform systematic biopsies (SBx) combined with targeted biopsies (TBx) in case of positive MRI (i.e. PI-RADS ≥ 3). To assess the utility of performing SBx in combination with TBx, we determined the added value of SBx brought to the diagnosis of PCa according to their sextant location and MRI target characteristics.
METHODS
METHODS
In our local prospectively collected database, we conducted a single-center retrospective study including all patients with a suspicion of PCa, who underwent transrectal ultrasound-guided (TRUS) prostate biopsies (PBx) with a prior MRI and a single lesion classified as PI-RADS ≥ 3. We have characterized the SBx according to their location on MRI: same sextant (S-SBx), adjacent sextant (A-SBx), ipsilateral side (I-SBx) and contralateral side (C-SBx). The added value of SBx and TBx was defined as any upgrading to significant PCa (csPCa) (ISUP ≥2).
RESULTS
RESULTS
371 patients were included in the study. The added value of SBx was 10% overall. Regarding the lesion location and the SBx sextant, the added value of SBx was: 5.1% for S-SBx, 5.4% for A-SBx, 4.9% for I-SBx and 1.9% for C-SBx. The overall added value of SBx was 6.8% for PI-RADS 3 lesions, 14% for PI-RADS 4 lesions and 6.7% for PI-RADS 5 lesions (p = 0.063). The added value of SBx for contralateral side was 1.9% (2/103), 3.1% (5/163) and 0% (0/105) for PI-RADS 3, PI-RADS 4 and PI-RADS 5 lesions, respectively (p = 0,4). The added value of SBx was lower when the number of TBx was higher (OR 0.57; CI 95% 0.37-0.85; p = 0.007).
CONCLUSIONS
CONCLUSIONS
Our results suggest that the utility of performing SBx in the contralateral lobe toward the MRI lesion was very low, supporting that they might be avoided.
Identifiants
pubmed: 38114598
doi: 10.1038/s41391-023-00770-3
pii: 10.1038/s41391-023-00770-3
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2023. The Author(s), under exclusive licence to Springer Nature Limited.
Références
Uroweb - European Association of Urology [Internet]. [cited 2022 Jun 6]. EAU Guidelines on Prostate Cancer - Uroweb. Available from: https://uroweb.org/guidelines/prostate-cancer .
Rouvière O, Puech P, Renard-Penna R, Claudon M, Roy C, Mège-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;20:100–9.
doi: 10.1016/S1470-2045(18)30569-2
pubmed: 30470502
Van der Leest M, Cornel E, Israël B, Hendriks R, Padhani AR, Hoogenboom M, et al. Head-to-head comparison of transrectal ultrasound-guided prostate biopsy versus multiparametric prostate resonance imaging with subsequent magnetic resonance-guided biopsy in biopsy-naïve men with elevated prostate-specific antigen: a large prospective multicenter clinical study. Eur Urol. 2019;75:570–8.
doi: 10.1016/j.eururo.2018.11.023
pubmed: 30477981
Drost FJH, Osses D, Nieboer D, Bangma CH, Steyerberg EW, Roobol MJ, et al. Prostate magnetic resonance imaging, with or without magnetic resonance imaging-targeted biopsy, and systematic biopsy for detecting prostate cancer: a cochrane systematic review and meta-analysis. Eur Urol. 2020;77:78–94.
doi: 10.1016/j.eururo.2019.06.023
pubmed: 31326219
Loeb S, Bjurlin MA, Nicholson J, Tammela TL, Penson DF, Carter HB, et al. Overdiagnosis and overtreatment of prostate cancer. Eur Urol. 2014;65:1046–55.
doi: 10.1016/j.eururo.2013.12.062
pubmed: 24439788
pmcid: 4113338
Chowdhury R, Abbas A, Idriz S, Hoy A, Rutherford EE, Smart JM. Should warfarin or aspirin be stopped prior to prostate biopsy? An analysis of bleeding complications related to increasing sample number regimes. Clin Radiol. 2012;67:e64–70.
doi: 10.1016/j.crad.2012.08.005
pubmed: 22959852
Eineluoto JT, Järvinen P, Kilpeläinen T, Lahdensuo K, Kalalahti I, Sandeman K, et al. Patient experience of systematic versus fusion prostate biopsies. Eur Urol Oncol. 2018;1:202–7.
doi: 10.1016/j.euo.2018.02.005
pubmed: 31102622
Kalalahti I, Huotari K, Erickson AM, Petas A, Vasarainen H, Rannikko A. Infectious complications after transrectal MRI-targeted and systematic prostate biopsy. World J Urol. 2022;40:2261–5.
doi: 10.1007/s00345-022-04104-1
pubmed: 35930069
pmcid: 9427867
Bryk DJ, Llukani E, Taneja SS, Rosenkrantz AB, Huang WC, Lepor H. The Role of Ipsilateral and contralateral transrectal ultrasound-guided systematic prostate biopsy in men with unilateral magnetic resonance imaging lesion undergoing magnetic resonance imaging-ultrasound fusion-targeted prostate biopsy. Urology. 2017;102:178–82.
doi: 10.1016/j.urology.2016.11.017
pubmed: 27871829
Freifeld Y, Xi Y, Passoni N, Woldu S, Hornberger B, Goldberg K, et al. Optimal sampling scheme in men with abnormal multiparametric MRI undergoing MRI-TRUS fusion prostate biopsy. Urol Oncol: Semin Orig Investig. 2019;37:57–62.
doi: 10.1016/j.urolonc.2018.10.009
Cata E, Andras I, Ferro M, Kadula P, Leucuta D, Musi G, et al. Systematic sampling during MRI-US fusion prostate biopsy can overcome errors of targeting—prospective single center experience after 300 cases in first biopsy setting. Transl Androl Urol. 2020;9:2510–8.
doi: 10.21037/tau-20-1001
pubmed: 33457225
pmcid: 7807351
Turkbey B, Rosenkrantz AB, Haider MA, Padhani AR, Villeirs G, Macura KJ, et al. Prostate imaging reporting and Data System Version 2.1: 2019 Update of Prostate Imaging Reporting and Data System Version 2. Eur Urol. 2019;76:340–51.
doi: 10.1016/j.eururo.2019.02.033
pubmed: 30898406
Epstein JI, Egevad L, Amin MB, Delahunt B, Srigley JR, Humphrey PA, et al. The 2014 International Society of Urological Pathology (ISUP) Consensus Conference on Gleason Grading of Prostatic Carcinoma: Definition of grading patterns and proposal for a new grading system. Am J Surg Pathol. 2016;40:244–52.
doi: 10.1097/PAS.0000000000000530
pubmed: 26492179
Dell’Oglio P, Stabile A, Soligo M, Brembilla G, Esposito A, Gandaglia G, et al. There is no way to avoid systematic prostate biopsies in addition to multiparametric magnetic resonance imaging targeted biopsies. Eur Urol Oncol. 2020;3:112–8.
doi: 10.1016/j.euo.2019.03.002
pubmed: 31411973
Ploussard G, Borgmann H, Briganti A, de Visschere P, Fütterer JJ, Gandaglia G, et al. Positive pre-biopsy MRI: are systematic biopsies still useful in addition to targeted biopsies? World J Urol. 2019;37:243–51.
doi: 10.1007/s00345-018-2399-z
pubmed: 29967944
Borghesi M, Ahmed H, Nam R, Schaeffer E, Schiavina R, Taneja S, et al. Complications after systematic, random, and image-guided prostate biopsy. Eur Urol. 2017;71:353–65.
doi: 10.1016/j.eururo.2016.08.004
pubmed: 27543165
Ahdoot M, Wilbur AR, Reese SE, Lebastchi AH, Mehralivand S, Gomella PT, et al. MRI-targeted, systematic, and combined biopsy for prostate cancer diagnosis. N. Engl J Med. 2020;382:917–28.
doi: 10.1056/NEJMoa1910038
pubmed: 32130814
pmcid: 7323919
Nobin JL, Orczyk C, Deng FM, Melamed J, Rusinek H, Taneja SS, et al. Prostate tumour volumes: evaluation of the agreement between magnetic resonance imaging and histology using novel co-registration software. BJU Int. 2014;114:E105–12.
doi: 10.1111/bju.12750
pubmed: 24673731
pmcid: 4714042
Padhani AR, Weinreb J, Rosenkrantz AB, Villeirs G, Turkbey B, Barentsz J. Prostate Imaging-Reporting and Data System Steering Committee: PI-RADS v2 Status Update and Future Directions. Eur Urol. 2019;75:385–96.
doi: 10.1016/j.eururo.2018.05.035
pubmed: 29908876
Brisbane WG, Priester AM, Ballon J, Kwan L, Delfin MK, Felker ER, et al. Targeted prostate biopsy: umbra, penumbra, and value of perilesional sampling. Eur Urol. 2022;82:303–10.
doi: 10.1016/j.eururo.2022.01.008
pubmed: 35115177
Lahoud J, Doan P, Kim L, Patel MI. Perilesional biopsies increase detection of significant prostate cancer in men with PI-RADS 4/5 Lesions: Validation of the PI-RADS Steering Committee Recommendation. Eur Urol. 2021;80:260–1.
doi: 10.1016/j.eururo.2021.01.039
pubmed: 33593652
Radtke JP. Multiparametric Magnetic Resonance Imaging (MRI) and MRI–Transrectal Ultrasound fusion biopsy for index tumor detection: correlation with radical prostatectomy specimen. Eur Urol. 2016;70;846–853.
Porpiglia F, Checcucci E, De Cillis S, Piramide F, Amparore D, Piana A, et al. A prospective randomized controlled trial comparing target prostate biopsy alone approach vs. target plus standard in naïve patients with positive mpMRI. Minerva Urol Nephrol. 2023;75;31–41.
Günzel K, Haas M, Maxeiner A, Stephan C, Buckendahl J, Asbach P, et al. Predictive parameters identifying men eligible for a sole MRI/Ultrasound fusion-guided targeted biopsy without an additional systematic biopsy. Urol Int. 2017;98:15–21.
doi: 10.1159/000449258
pubmed: 27618633
Kasivisvanathan V, Rannikko AS, Borghi M, Panebianco V, Mynderse LA, Vaarala MH, et al. MRI-targeted or standard biopsy for prostate-cancer diagnosis. N. Engl J Med. 2018;378:1767–77.
doi: 10.1056/NEJMoa1801993
pubmed: 29552975
pmcid: 9084630
Ploussard G, Beauval JB, Renard-Penna R, Lesourd M, Manceau C, Almeras C, et al. Assessment of the minimal targeted biopsy core number per MRI Lesion for improving prostate cancer grading prediction. J Clin Med. 2020;9:225.
doi: 10.3390/jcm9010225
pubmed: 31952120
pmcid: 7019328
Calio BP, Sidana A, Sugano D, Gaur S, Maruf M, Jain AL, et al. Risk of upgrading from prostate biopsy to radical prostatectomy pathology—does saturation biopsy of index lesion during multiparametric magnetic resonance imaging-transrectal ultrasound fusion biopsy help? J Urol. 2018;199:976–82.
doi: 10.1016/j.juro.2017.10.048
pubmed: 29154904
pmcid: 7983157
Diamand R, Hollans M, Lefebvre Y, Sirtaine N, Limani K, Hawaux E, et al. The role of perilesional and multiparametric resonance imaging-targeted biopsies to reduce the risk of upgrading at radical prostatectomy pathology: A retrospective monocentric study. Urol Oncol: Semin Orig Investig. 2022;40:192.e11–192.e17.
Falagario U, Jambor I, Taimen P, Syvänen KT, Kähkönen E, Merisaari H, et al. Added value of systematic biopsy in men with a clinical suspicion of prostate cancer undergoing biparametric MRI-targeted biopsy: multi-institutional external validation study. World J Urol. 2021;39:1879–87.
doi: 10.1007/s00345-020-03393-8
pubmed: 32778912
Uleri A, Baboudjian M, Tedde A, Gallioli A, Long-Depaquit T, Palou J, et al. Is there an impact of transperineal versus transrectal magnetic resonance imaging–targeted biopsy in clinically significant prostate cancer detection rate? A systematic review and meta-analysis. Eur Urol Oncol. 2023;6:621–8.