MRI-guided in-bore biopsy of the prostate - defining the optimal number of cores needed.
Humans
Male
Prostatic Neoplasms
/ pathology
Retrospective Studies
Aged
Image-Guided Biopsy
/ methods
Middle Aged
Prostate
/ pathology
Magnetic Resonance Imaging
/ methods
Biopsy, Large-Core Needle
/ methods
Neoplasm Grading
Magnetic Resonance Imaging, Interventional
/ methods
Multiparametric Magnetic Resonance Imaging
/ methods
In-bore
In-gantry
MRI-targeted
Number of cores
Prostate biopsy
Journal
Cancer imaging : the official publication of the International Cancer Imaging Society
ISSN: 1470-7330
Titre abrégé: Cancer Imaging
Pays: England
ID NLM: 101172931
Informations de publication
Date de publication:
01 Jul 2024
01 Jul 2024
Historique:
received:
24
03
2023
accepted:
25
06
2024
medline:
3
7
2024
pubmed:
3
7
2024
entrez:
3
7
2024
Statut:
epublish
Résumé
Numerous studies have shown that magnetic resonance imaging (MRI)-targeted biopsy approaches are superior to traditional systematic transrectal ultrasound guided biopsy (TRUS-Bx). The optimal number of biopsy cores to be obtained per lesion identified on multiparametric MRI (mpMRI) images, however, remains a matter of debate. The aim of this study was to evaluate the incremental value of additional biopsy cores in an MRI-targeted "in-bore"-biopsy (MRI-Bx) setting. Two hundred and forty-five patients, who underwent MRI-Bx between June 2014 and September 2021, were included in this retrospective single-center analysis. All lesions were biopsied with at least five biopsy cores and cumulative detection rates for any cancer (PCa) as well as detection rates of clinically significant cancers (csPCa) were calculated for each sequentially labeled biopsy core. The cumulative per-core detection rates are presented as whole numbers and as proportion of the maximum detection rate reached, when all biopsy cores were considered. CsPCa was defined as Gleason Score (GS) ≥ 7 (3 + 4). One hundred and thirty-two of 245 Patients (53.9%) were diagnosed with prostate cancer and csPCa was found in 64 (26.1%) patients. The first biopsy core revealed csPCa/ PCa in 76.6% (49/64)/ 81.8% (108/132) of cases. The second, third and fourth core found csPCa/ PCa not detected by previous cores in 10.9% (7/64)/ 8.3% (11/132), 7.8% (5/64)/ 5.3% (7/132) and 3.1% (2/64)/ 3% (4/132) of cases, respectively. Obtaining one or more cores beyond the fourth biopsy core resulted in an increase in detection rate of 1.6% (1/64)/ 1.5% (2/132). We found that obtaining five cores per lesion maximized detection rates. If, however, future research should establish a clear link between the incidence of serious complications and the number of biopsy cores obtained, a three-core biopsy might suffice as our results suggest that about 95% of all csPCa are detected by the first three cores.
Sections du résumé
BACKGROUND
BACKGROUND
Numerous studies have shown that magnetic resonance imaging (MRI)-targeted biopsy approaches are superior to traditional systematic transrectal ultrasound guided biopsy (TRUS-Bx). The optimal number of biopsy cores to be obtained per lesion identified on multiparametric MRI (mpMRI) images, however, remains a matter of debate. The aim of this study was to evaluate the incremental value of additional biopsy cores in an MRI-targeted "in-bore"-biopsy (MRI-Bx) setting.
PATIENTS AND METHODS
METHODS
Two hundred and forty-five patients, who underwent MRI-Bx between June 2014 and September 2021, were included in this retrospective single-center analysis. All lesions were biopsied with at least five biopsy cores and cumulative detection rates for any cancer (PCa) as well as detection rates of clinically significant cancers (csPCa) were calculated for each sequentially labeled biopsy core. The cumulative per-core detection rates are presented as whole numbers and as proportion of the maximum detection rate reached, when all biopsy cores were considered. CsPCa was defined as Gleason Score (GS) ≥ 7 (3 + 4).
RESULTS
RESULTS
One hundred and thirty-two of 245 Patients (53.9%) were diagnosed with prostate cancer and csPCa was found in 64 (26.1%) patients. The first biopsy core revealed csPCa/ PCa in 76.6% (49/64)/ 81.8% (108/132) of cases. The second, third and fourth core found csPCa/ PCa not detected by previous cores in 10.9% (7/64)/ 8.3% (11/132), 7.8% (5/64)/ 5.3% (7/132) and 3.1% (2/64)/ 3% (4/132) of cases, respectively. Obtaining one or more cores beyond the fourth biopsy core resulted in an increase in detection rate of 1.6% (1/64)/ 1.5% (2/132).
CONCLUSION
CONCLUSIONS
We found that obtaining five cores per lesion maximized detection rates. If, however, future research should establish a clear link between the incidence of serious complications and the number of biopsy cores obtained, a three-core biopsy might suffice as our results suggest that about 95% of all csPCa are detected by the first three cores.
Identifiants
pubmed: 38956721
doi: 10.1186/s40644-024-00734-3
pii: 10.1186/s40644-024-00734-3
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
81Informations de copyright
© 2024. The Author(s).
Références
Harvey CJ, Pilcher J, Richenberg J, Patel U, Frauscher F. Applications of transrectal ultrasound in prostate cancer. Br J Radiol. 2012;85(Spec Iss 1):S3–17.
doi: 10.1259/bjr/56357549
pubmed: 22844031
pmcid: 3746408
Walz J, Graefen M, Chun FKH, Erbersdobler A, Haese A, Steuber T, et al. High incidence of prostate Cancer detected by Saturation Biopsy after previous negative Biopsy Series. Eur Urol. 2006;50(3):498–505.
doi: 10.1016/j.eururo.2006.03.026
pubmed: 16631303
Bittner N, Merrick GS, Butler WM, Bennett A, Galbreath RW. Incidence and pathological features of prostate Cancer detected on Transperineal Template guided Mapping Biopsy after negative Transrectal Ultrasound guided Biopsy. J Urol. 2013;190(2):509–14.
doi: 10.1016/j.juro.2013.02.021
pubmed: 23416641
Matoso A, Epstein JI. Defining clinically significant prostate cancer on the basis of pathological findings. Histopathology. 2019;74(1):135–45.
doi: 10.1111/his.13712
pubmed: 30565298
Serefoglu EC, Altinova S, Ugras NS, Akincioglu E, Asil E, Balbay MD. How reliable is 12-core prostate biopsy procedure in the detection of prostate cancer? Can Urol Assoc J. 2013;7(5–6):E293–8.
doi: 10.5489/cuaj.1248
pubmed: 22398204
pmcid: 3668408
Mottet N, van den Bergh RCN, Briers E, Van den Broeck T, Cumberbatch MG, 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. Eur Urol. 2021;1(2):243–62.
doi: 10.1016/j.eururo.2020.09.042
Drost FH, Osses DF, Nieboer D, Steyerberg EW, Bangma CH, 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(1):78–94.
doi: 10.1016/j.eururo.2019.06.023
pubmed: 31326219
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;10(19):1767–77.
doi: 10.1056/NEJMoa1801993
Porpiglia F, DE Luca S, Passera R, Manfredi M, Mele F, Bollito E, et al. Multiparametric-magnetic Resonance/Ultrasound Fusion targeted prostate biopsy improves Agreement between Biopsy and Radical Prostatectomy Gleason Score. Anticancer Res. 2016;36(9):4833–9.
doi: 10.21873/anticanres.11045
pubmed: 27630337
Wegelin O, Exterkate L, van der Leest M, Kummer JA, Vreuls W, de Bruin PC, 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):582–90.
doi: 10.1016/j.eururo.2018.11.040
pubmed: 30522912
Giganti F, Moore CM. A critical comparison of techniques for MRI-targeted biopsy of the prostate. Transl Androl Urol. 2017;6(3):432–43.
doi: 10.21037/tau.2017.03.77
pubmed: 28725585
pmcid: 5503959
Costa DN, Goldberg K, de Leon AD, Lotan Y, Xi Y, Aziz M, et al. Magnetic resonance imaging–guided In-bore and magnetic resonance imaging-transrectal Ultrasound Fusion targeted prostate biopsies: an adjusted comparison of clinically significant prostate Cancer detection rate. Eur Urol Oncol. 2019;2(4):397–404.
doi: 10.1016/j.euo.2018.08.022
pubmed: 31277776
Prince M, Foster BR, Kaempf A, Liu JJ, Amling CL, Isharwal S, et al. In-Bore Versus Fusion MRI–Targeted biopsy of PI-RADS category 4 and 5 lesions: a retrospective comparative analysis using propensity score weighting. AJR Am J Roentgenol. 2021;217(5):1123–30.
doi: 10.2214/AJR.20.25207
pubmed: 33646819
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;5(10):917–28.
doi: 10.1056/NEJMoa1910038
Wegelin O, Exterkate L, van der Leest M, Kelder JC, Bosch JLHR, Barentsz JO, 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;2(6):617–24.
doi: 10.1016/j.euo.2019.08.007
pubmed: 31519516
Schimmöller L, Quentin M, Blondin D, Dietzel F, Hiester A, Schleich C, et al. Targeted MRI-guided prostate biopsy: are two biopsy cores per MRI-lesion required? Eur Radiol. 2016;1(11):3858–64.
doi: 10.1007/s00330-016-4266-x
Subramanian N, Recchimuzzi DZ, Xi Y, Diaz de Leon A, Chen H, Xie D, et al. Impact of the number of cores on the prostate Cancer detection rate in men undergoing in-bore magnetic resonance imaging-guided targeted biopsies. J Comput Assist Tomogr. 2021;1(2):203–9.
doi: 10.1097/RCT.0000000000001115
Seyfried N, Mahran A, Panda A, Obmann VC, Buzzy CA, Jiang Y, et al. Diagnostic Yield of Incremental Biopsy cores and Second Lesion Sampling for In-Gantry MRI-Guided prostate biopsy. AJR Am J Roentgenol. 2021;217(4):908–18.
doi: 10.2214/AJR.20.24918
pubmed: 33336582
Barentsz JO, Richenberg J, Clements R, Choyke P, Verma S, Villeirs G, et al. ESUR prostate MR guidelines 2012. Eur Radiol. 2012;1(4):746–57.
doi: 10.1007/s00330-011-2377-y
Weinreb JC, Barentsz JO, Choyke PL, Cornud F, Haider MA, Macura KJ, et al. Eur Urol. 2016;69(1):16–40. PI-RADS Prostate Imaging – Reporting and Data System: 2015, Version 2.
Turkbey B, Rosenkrantz AB, Haider MA, Padhani AR, Villeirs G, Macura KJ, et al. Eur Urol. 2019;76(3):340–51. Prostate Imaging Reporting and Data System Version 2.1: 2019 Update of Prostate Imaging Reporting and Data System Version 2.
Friedl A, Schneeweiss J, Sevcenco S, Eredics K, Kunit T, Susani M, et al. In-bore 3.0-T magnetic resonance imaging-guided Transrectal targeted prostate biopsy in a repeat Biopsy Population: diagnostic performance, complications, and learning curve. Urology. 2018;1:114:139–46.
doi: 10.1016/j.urology.2017.12.032
Epstein JI, Egevad L, Amin MB, Delahunt B, Srigley JR, Humphrey PA. 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(2):244–52.
van Leenders GJLH, van der Kwast TH, Grignon DJ, Evans AJ, Kristiansen G, Kweldam CF, et al. The 2019 International Society of Urological Pathology (ISUP) Consensus Conference on Grading of Prostatic Carcinoma. Am J Surg Pathol. 2020;44(8):e87–99.
doi: 10.1097/PAS.0000000000001497
pubmed: 32459716
pmcid: 7382533
Epstein JI, Amin MB, Fine SW, Algaba F, Aron M, Baydar DE, et al. The 2019 Genitourinary Pathology Society (GUPS) White Paper on contemporary grading of prostate Cancer. Arch Pathol Lab Med. 2021;1(4):461–93.
doi: 10.5858/arpa.2020-0015-RA
Pooli A, Johnson DC, Shirk J, Markovic D, Sadun TY, Sisk AE, et al. Predicting pathological tumor size in prostate Cancer based on Multiparametric Prostate Magnetic Resonance Imaging and preoperative findings. J Urol. 2021;205(2):444–51.
doi: 10.1097/JU.0000000000001389
pubmed: 33026934
Aihara M, Wheeler TM, Ohori M, Scardino PT. Heterogeneity of prostate cancer inradical prostatectomy specimens. Urology. 1994;1(1):60–6.
doi: 10.1016/S0090-4295(94)80264-5
Zhang M, Milot L, Khalvati F, Sugar L, Downes M, Baig SM, et al. Value of increasing Biopsy cores per target with cognitive MRI-targeted transrectal US prostate biopsy. Radiology. 2019;291(1):83–9.
doi: 10.1148/radiol.2019180712
pubmed: 30694165
Tracy CR, Flynn KJ, Sjoberg DD, Gellhaus PT, Metz CM, Ehdaie B. Optimizing MRI-targeted prostate biopsy: the diagnostic benefit of additional targeted biopsy cores. Urol Oncol. 2021;1;39(3):193.e1-193.e6.
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;1(3):353–65.
doi: 10.1016/j.eururo.2016.08.004
Rosario DJ, Lane JA, Metcalfe C, Donovan JL, Doble A, Goodwin L, et al. Short term outcomes of prostate biopsy in men tested for cancer by prostate specific antigen: prospective evaluation within ProtecT study. BMJ. 2012;9:344:d7894.
doi: 10.1136/bmj.d7894
Ghani KR, Dundas D, Patel U. Bleeding after transrectal ultrasonography-guided prostate biopsy: a study of 7-day morbidity after a six-, eight- and 12-core biopsy protocol. BJU Int. 2004;94(7):1014–20.
doi: 10.1111/j.1464-410X.2004.05096.x
pubmed: 15541119
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(12):e64–70.
doi: 10.1016/j.crad.2012.08.005
pubmed: 22959852
Loeb S, Vellekoop A, Ahmed HU, Catto J, Emberton M, Nam R, et al. Syst Rev Complications Prostate Biopsy Eur Urol. 2013;1(6):876–92.
Raaijmakers R, Kirkels WJ, Roobol MJ, Wildhagen MF, Schrder FH. Complication rates and risk factors of 5802 transrectal ultrasound-guided sextant biopsies of the prostate within a population-based screening program. Urology. 2002;60(5):826–30.
doi: 10.1016/S0090-4295(02)01958-1
pubmed: 12429309
Pepe P, Aragona F. Morbidity after transperineal prostate biopsy in 3000 patients undergoing 12 vs 18 vs more than 24 needle cores. Urology. 2013;1(6):1142–6.
doi: 10.1016/j.urology.2013.02.019
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(9):2261–5.
doi: 10.1007/s00345-022-04104-1
pubmed: 35930069
pmcid: 9427867
Pradere Ba, Veeratterapillay R c, Dimitropoulos K d, Yuan Y e, Omar MI f, MacLennan S et al. g,. Nonantibiotic Strategies for the Prevention of Infectious Complications following Prostate Biopsy: A Systematic Review and Meta-Analysis. J Urol. 2021;205(3):653–63.