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Can fewer transperineal systematic biopsy cores have the same prostate cancer detection rate as of magnetic resonance imaging/ultrasound fusion biopsy?

Prostate Cancer and Prostatic Diseases volume 23, pages 589–595 (2020)Cite this article

Subjects

Abstracts

Background

Due to the discomfort and incidence of complications increases with the increasing number of biopsy cores, the protocol of prostate biopsy has been promoted from systematic biopsy (SB) to targeted biopsy (TB) in many studies. However, the optimal prostate sampling scheme to balance the incidence of biopsy complications and accuracy of biopsy remains controversial. Our objective is to explore an optimal prostate cancer (PCa) sampling scheme with fewer SB cores.

Methods

Patients with at least one lesion of Prostate Imaging Reporting and Data System ≥3 were prospectively enrolled. TB and SB were performed for each patient as reference. The hypothetical biopsy sampling schemes were TB only, SB only, and TB followed by SB of the nontargeted sector (TB+nSB). The PCa and clinically significant PCa (csPCa) detection rates and cores of the three hypothetical biopsy schemes were compared with TB+SB.

Results

Among 165 patients, 107 (64.8%) were diagnosed with PCa and 91 (55.2%) with csPCa via TB+SB. There were 54 (50.5%) and 42 (46.2%) magnetic resonance imaging (MRI) true negative cases and 53 (49.5%) and 49 (53.8%) false negative cases of nontargeted sectors among PCa and csPCa patients, respectively. The maximal cancer proportion in positive biopsy cases differed significantly between the true and false groups of these cohorts. There was no difference between TB+nSB and TB+SB for PCa or csPCa detection.

Conclusions

The optimal sampling scheme TB+nSB with fewer SB cores showed same PCa and csPCa detection rates as that of standard TB+SB with MRI/ultrasound fusion biopsy.

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Fig. 1: The targeted and nontargeted sectors of prostate(Illustrated by Yuanyuan Li).

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Acknowledgements

HL and MJR contributed equally to this work. We thank the entire staff of the Department of Urology, Peking University First Hospital.

Author contributions

HL and MJR contributed equally to this work. GS conceived and designed the study. HL, MJR, Hao Wang, and GS collected the data. He Wang analyzed mpMRI results. HL, MJR, and XYL analyzed and interpreted the data. HL drafted the manuscript. GS revised the manuscript. All authors read and approved the final manuscript.

Funding

This study was supported by Joint Fund of Peking University (BMU2020MI003).

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Authors and Affiliations

  1. The Department of Urology, Peking University First Hospital, 100034, Beijing, China

    Hua Liu, Mingjian Ruan, Hao Wang & Gang Song

  2. The Institute of Urology, Peking University, 100034, Beijing, China

    Hua Liu, Mingjian Ruan, Hao Wang & Gang Song

  3. The National Urological Cancer Center of China, 100034, Beijing, China

    Hua Liu, Mingjian Ruan, Hao Wang & Gang Song

  4. The Department of Radiology, Peking University First Hospital, 100034, Beijing, China

    He Wang

  5. The Department of Statistics, Peking University First Hospital, 100034, Beijing, China

    Xueying Li

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  1. Hua Liu
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Correspondence to Gang Song.

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Liu, H., Ruan, M., Wang, H. et al. Can fewer transperineal systematic biopsy cores have the same prostate cancer detection rate as of magnetic resonance imaging/ultrasound fusion biopsy?. Prostate Cancer Prostatic Dis 23, 589–595 (2020). https://doi.org/10.1038/s41391-020-0260-0

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