Mp31-11 Comparison of Computer-Assisted Mri Fusion Guided Prostate Biopsies With Cognitive-Assisted Mri Fusion Biopsies

You have accessJournal of UrologyProstate Cancer: Detection & Screening III (MP31)1 May 2024MP31-11 COMPARISON OF COMPUTER-ASSISTED MRI FUSION GUIDED PROSTATE BIOPSIES WITH COGNITIVE-ASSISTED MRI FUSION BIOPSIES Tonya S. King, Genesis G. Dolgetta, Benjamin J. Behers, Spencer Kortum, Joshua Davis, Christopher W. Guske, Tyler Vidal, and Robert I. Carey Tonya S. KingTonya S. King , Genesis G. DolgettaGenesis G. Dolgetta , Benjamin J. BehersBenjamin J. Behers , Spencer KortumSpencer Kortum , Joshua DavisJoshua Davis , Christopher W. GuskeChristopher W. Guske , Tyler VidalTyler Vidal , and Robert I. CareyRobert I. Carey View All Author Informationhttps://doi.org/10.1097/01.JU.0001008936.35187.0b.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Multiparametric magnetic resonance imaging (MRI) of the prostate is being developed at many levels to improve diagnostic accuracy of prostate biopsies in men who have elevated PSA levels. As MRI fusion technology is adopted into a community, it is not known how well prostate biopsies guided by computer-assisted MRI (CA-MRI) fusion compare with cognitive-assisted MRI (Cog-MRI) pre-existing as standard of care (SOC) in that community. METHODS: This IRB approved retrospective database compares 1074 CA-MRI fusion biopsies of the prostate with 128 Cog-MRI fusion guided biopsies of the prostate. All biopsies were performed over a common period of five years in a consistent manner transrectally using the same fusion technology and systematic biopsies were obtained at the same setting. All CA- MRI fusion biopsies were performed with the Artemis (Innomedicus) MRI Fusion device in an operating room under propofol anesthesia by a community of 12 urologists. All Cog-MRI fusion biopsies were performed with a B&K 3000 Ultrasound under local lidocaine anesthesia only by a single urologist. Data was collected and analyzed with SAS statistical software. RESULTS: Cog-MRI biopsy positivity rates for PI-RADS 3 (4/7, 57.1%), PI-RADS 4 (43/52,82.7%), PI-RADS 5 (38/42, 90.5%, and PI-RADS 3-5 (85/101, 84.2%) are superior in every category compared to CA-MRI positivity rates for PI-RADS 3 (50/89, 56.1%), PI-RADS 4 (403/538, 74.9%), PI-RADS 5 (262/298, 88.2%), and PI-RADS 3-5 (715/925, 77.3%). There is no significant difference between mean BMI of the Cog-MRI (27.8) and CA-MRI (27.4) groups (p=0.31) or the PSA (10.1 and 9.1, respectively, p=0.55). There was no significant difference in the detection of Gleason 6 cancer in any of the groups but there was a lower percentage of Gleason 6 in the Cog-MRI PI-RADS 5 group (5.3%) than in the CA-MRI PI-RADS 5 group (13.2%). Baseline transrectal ultrasound guided biopsies (n=428) done without prior MRI during this period demonstrated 59.1% positivity. CONCLUSIONS: Despite the significantly higher cost of performing CA-MRI biopsies in this study, prostate biopsy positivity is superior for Cog-MRI fusion biopsies for PI-RADS classifications 3, 4, 5, and combined 3-5 compared to CA-MRI fusion biopsies. Fewer Gleason 6 cancers were found in PI-RADS 5 lesions in Cog-MRI biopsies than CA-MRI biopsies. Both CA-MRI and Cog-MRI fusion biopsied outperformed standard TRUS biopsies done without prior MRI imaging. The 84.2% positivity rate in this study for all PI-RADS 3-5 Cog-MRI fusion biopsies should be a reasonable benchmark for CA-MRI fusion technology to achieve. Source of Funding: The Burzik Foundation © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e508 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Tonya S. King More articles by this author Genesis G. Dolgetta More articles by this author Benjamin J. Behers More articles by this author Spencer Kortum More articles by this author Joshua Davis More articles by this author Christopher W. Guske More articles by this author Tyler Vidal More articles by this author Robert I. Carey More articles by this author Expand All Advertisement PDF downloadLoading ...