Mp43-06 Is It Time to Abandon the Transrectal Probe in Prostate Biopsy?

You have accessJournal of UrologySurgical Technology & Simulation: Instrumentation & Technology II (MP43)1 May 2024MP43-06 IS IT TIME TO ABANDON THE TRANSRECTAL PROBE IN PROSTATE BIOPSY? William S. Azar, Christopher R. Koller, Sahil H. Parikh, Charles Hesswani, Kyle C. Schuppe, Sarah S. Azari, Alexander P. Kenigsberg, Neil Mendhiratta, Jason Hyman, Jibriel Noun, Jayant Siva, Daniel Nethala, David G. Gelikman, Maria J. Merino, Howard S. Parnes, Bradford J. Wood, Ismail Baris Turkbey, Sandeep Gurram, Sheng Xu, and Peter A. Pinto William S. AzarWilliam S. Azar , Christopher R. KollerChristopher R. Koller , Sahil H. ParikhSahil H. Parikh , Charles HesswaniCharles Hesswani , Kyle C. SchuppeKyle C. Schuppe , Sarah S. AzariSarah S. Azari , Alexander P. KenigsbergAlexander P. Kenigsberg , Neil MendhirattaNeil Mendhiratta , Jason HymanJason Hyman , Jibriel NounJibriel Noun , Jayant SivaJayant Siva , Daniel NethalaDaniel Nethala , David G. GelikmanDavid G. Gelikman , Maria J. MerinoMaria J. Merino , Howard S. ParnesHoward S. Parnes , Bradford J. WoodBradford J. Wood , Ismail Baris TurkbeyIsmail Baris Turkbey , Sandeep GurramSandeep Gurram , Sheng XuSheng Xu , and Peter A. PintoPeter A. Pinto View All Author Informationhttps://doi.org/10.1097/01.JU.0001008720.96896.83.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: New biopsy techniques are emerging to enhance the detection rate of prostate cancer (PCa). For years, transrectal (TR) ultrasound (US)-guided biopsies remained the standard approach. More recently, a transition from TR biopsy to transperineal (TP) biopsy with a TR probe has gained popularity, primarily over concerns of infection risk. The use of a TR probe, however, remains a suboptimal option from a patient comfort and hygiene standpoint. In this study, we assess the performance of a totally TP (TTP) MRI fusion biopsy technique that utilizes a TP US probe instead of a traditional TR probe (Figure 1). METHODS: Between 2021 and 2023, patients were enrolled on a clinical trial undergoing TTP and TP MRI fusion targeted prostate biopsy. TP biopsies were performed using the UroNav MRI/US fusion biopsy platform with a TR side fire US probe, while TTP biopsies used a TP curved array US probe. A novel software platform was developed to allow TP US fusion in real time with prostate MRI utilizing electromagnetic tracking. Cancer detection rates (CDR) of TTP and TP biopsy were compared using McNemar's test on a per-patient and per-lesion basis. Baseline and clinical characteristics including grade group (GG), percentage of biopsy core involvement, size of tumor on biopsy, prostate volume and lesion size on MRI were assessed using two-sample t-tests and X2 tests. RESULTS: A total of 276 prostate lesions were biopsied from 143 patients who underwent prostate biopsy using both TTP and TP methods for each lesion in the same biopsy session. On a per-patient analysis, McNemar's test showed no significant difference in CDR using TTP vs TP methods for overall PCa (57%, p=1) and for csPCa (32% vs 36%, p=0.4). On a per-lesion analysis, McNemar's test showed no significant difference in CDR using TTP vs TP methods for overall PCa (46% vs 48%, p=0.6) and for csPCa (22% vs 26%, p=0.3). CONCLUSIONS: Our novel TTP biopsy method has shown comparable CDR to the traditional TP biopsy in detecting prostate cancer, without the need for an US probe in the rectum. Further design development and technique refinement will aim to optimize this new platform's availability for commercialization. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e694 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information William S. Azar More articles by this author Christopher R. Koller More articles by this author Sahil H. Parikh More articles by this author Charles Hesswani More articles by this author Kyle C. Schuppe More articles by this author Sarah S. Azari More articles by this author Alexander P. Kenigsberg More articles by this author Neil Mendhiratta More articles by this author Jason Hyman More articles by this author Jibriel Noun More articles by this author Jayant Siva More articles by this author Daniel Nethala More articles by this author David G. Gelikman More articles by this author Maria J. Merino More articles by this author Howard S. Parnes More articles by this author Bradford J. Wood More articles by this author Ismail Baris Turkbey More articles by this author Sandeep Gurram More articles by this author Sheng Xu More articles by this author Peter A. Pinto More articles by this author Expand All Advertisement PDF downloadLoading ...