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Mischinger, J; Kaufmann, S; Russo, GI; Harland, N; Rausch, S; Amend, B; Scharpf, M; Loewe, L; Todenhoefer, T; Notohamiprodjo, M; Nikolaou, K; Stenzl, A; Bedke, J; Kruck, S.
Targeted vs systematic robot-assisted transperineal magnetic resonance imaging-transrectal ultrasonography fusion prostate biopsy.
BJU Int. 2018; 121(5):791-798
Doi: 10.1111/bju.14089
[OPEN ACCESS]
Web of Science
PubMed
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- Führende Autor*innen der Med Uni Graz
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Mischinger Johannes
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- Abstract:
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To evaluate the performance of transperineal robot-assisted (RA) targeted (TB) and systematic (SB) prostate biopsy in primary and repeat biopsy settings.
Patients underwent RA biopsy between 2014 and 2016. Before RA-TB, multiparametric magnetic resonance imaging (mpMRI) was performed. Prostate lesions were scored (Prostate Imaging, Reporting and Data System, version 2) and used for RA-TB planning. In addition, RA-SB was performed. Available, whole-gland pathology was analysed.
In all, 130 patients were biopsy naive and 72 had had a previous negative transrectal ultrasonography-guided biopsy. In total, 202 patients had suspicious mpMRI lesions. Clinically significant prostate cancer was found in 85% of all prostate cancer cases (n = 123). Total and clinically significant prostate cancer detection rates for RA-TB vs RA-SB were not significantly different at 77% vs 84% and 80% vs 82%, respectively. RA-TB demonstrated a better sampling performance compared to RA-SB (26.4% vs 13.9%; P < 0.001).
Transperineal RA-TB and -SB showed similar clinically significant prostate cancer detection rates in primary and repeat biopsy settings. However, RA-TB offered a 50% reduction in biopsy cores. Omitting RA-SB is associated with a significant risk of missing clinically significant prostate cancer.
© 2017 The Authors BJU International © 2017 BJU International Published by John Wiley & Sons Ltd.
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robot-assisted transperineal prostate biopsy
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mpMRI-TRUS fusion
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targeted biopsy
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Prostate Imaging Reporting and Data System
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#PCSM
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#ProstateCancer