Academic Journal
Reducing the number of systematic biopsy cores in the era of MRI targeted biopsy—implications on clinically-significant prostate cancer detection and relevance to focal therapy planning
العنوان: | Reducing the number of systematic biopsy cores in the era of MRI targeted biopsy—implications on clinically-significant prostate cancer detection and relevance to focal therapy planning |
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المؤلفون: | Lee, Alvin Y. M., Chen, Kenneth, Tan, Yu Guang, Lee, Han Jie, Shutchaidat, Vipatsorn, Fook-Chong, Stephanie, Cheng, Christopher W. S., Ho, Henry S. S., Yuen, John S. P., Ngo, Nye Thane, Law, Yan Mee, Tay, Kae Jack |
المصدر: | Prostate Cancer and Prostatic Diseases ; volume 25, issue 4, page 720-726 ; ISSN 1365-7852 1476-5608 |
بيانات النشر: | Springer Science and Business Media LLC |
سنة النشر: | 2022 |
الوصف: | Background The optimal number of systematic biopsy cores in the era of multi-parametric MRI targeted biopsy remains unclear, especially on its impact of focal therapy planning. Our objective is to investigate the impact of reducing the number of systematic cores on prostate cancer detection in the era of MRI-US fusion targeted biopsy and as well as its relevance in template planning for focal therapy. Materials and methods A retrospective analysis of 398 consecutive men who underwent both systematic saturation (~24 cores) and MRI-US fusion targeted biopsy was performed. Four reduced-core systematic biopsy strategies (two-thirds, half, one-third and one-quarter systematic cores) were modelled and the detection rates of clinically-significant prostate cancer (csPCa defined as grade group ≥2) were compared to that of a full systematic biopsy using McNemar’s test. Focal therapy treatment plans were made based on positive cores on combined (targeted and systematic) biopsy and the various reduced-cores strategies to compare the proportion who had a change in treatment plan. Results csPCa was detected in 42% (168/398) of this patient cohort. Non-targeted systematic saturation biopsy had a 21% (83/398) csPCa detection rate. Our four strategies reduced the mean number of non-targeted systematic cores from 21.8 to 14.5, 10.9, 7.3 and 5.4 cores and their csPCa detection rates were significantly decreased to 16%, 13%, 9% and 8% respectively (all p < 0.05). Compared to the reduced-core strategies, a full systematic saturation biopsy resulted in change to the focal therapy treatment plan in 12% (2/3 cores), 19% (1/2 cores), 24% (1/3 cores) and 29% (1/4 cores) of the time ( p = 0.0434). Conclusions Reducing the number of systematic biopsies when performing an MRI-targeted biopsy leads to reduced detection of csPCa and alter the treatment plans for focal therapy, possibly limiting its oncological efficacy. |
نوع الوثيقة: | article in journal/newspaper |
اللغة: | English |
DOI: | 10.1038/s41391-021-00485-3 |
الاتاحة: | http://dx.doi.org/10.1038/s41391-021-00485-3 https://www.nature.com/articles/s41391-021-00485-3.pdf https://www.nature.com/articles/s41391-021-00485-3 |
Rights: | https://creativecommons.org/licenses/by/4.0 ; https://creativecommons.org/licenses/by/4.0 |
رقم الانضمام: | edsbas.62FC3318 |
قاعدة البيانات: | BASE |
DOI: | 10.1038/s41391-021-00485-3 |
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