Mp19-14 Clinical Significance of the Combined Standard 12-Core With Concomitant Image-Guided Prostate Biopsy. Can the Image-Guided Biopsy Stand on Its Own?

You have accessJournal of UrologyProstate Cancer: Detection & Screening I (MP19)1 May 2024MP19-14 CLINICAL SIGNIFICANCE OF THE COMBINED STANDARD 12-CORE WITH CONCOMITANT IMAGE-GUIDED PROSTATE BIOPSY. CAN THE IMAGE-GUIDED BIOPSY STAND ON ITS OWN? Alex Seabury, Yousif Shakroo, Dharam M. Ramnani, Junqi M. Qian, and Charles A. Seabury Alex SeaburyAlex Seabury , Yousif ShakrooYousif Shakroo , Dharam M. RamnaniDharam M. Ramnani , Junqi M. QianJunqi M. Qian , and Charles A. SeaburyCharles A. Seabury View All Author Informationhttps://doi.org/10.1097/01.JU.0001008716.22569.77.14AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Magnetic Resonance Imaging of the prostate (MRIP) has been increasingly utilized for the detection of prostate cancer in conjunction with transrectal ultrasound guided prostate biopsy (TRUS Bx). Studies have shown the utility of the MRI in isolating malignancy of varying clinical significance based on the Prostate Imaging Reporting and Data System (PIRADS). With the accuracy of MRIP and utilizing image-guided biopsy of targeted lesion (Fusion Bx), the question has been raised of omitting the Standard 12 core biopsy of the prostate performed concomitantly. The purpose of this study was to determine whether Fusion Bx is accurate enough to replace the Combined Fusion Bx and Standard TRUS Bx in a high volume, single Urology group in the detection of Grade group 2 or greater, clinically significant disease, and if Fusion biopsy alone significantly outperformed Standard biopsy. METHODS: Data was collected retrospectively from all patients that received a Combined biopsy from 11/1/22 to 6/8/23 at Virginia Urology. MRIP was labeled by 1 of 6 Virginia Urology Radiologists or from Virginia Commonwealth University. Patients with PI-RADS 3 and above were included. A Combined biopsy was performed by 1 of 10 surgeons using the UroNav system in a single location. Pathology was performed or confirmed by 2 pathologists at Virginia Urology. Patient information was entered into an Excel spreadsheet and analyzed using chi-square and t-test. Though all data was obtained, the focus was on Grade group 2 or greater, clinically significant, prostate cancer (csPCA). RESULTS: A total of 474 individual patients were identified. MRIP results showed 152 (30.2%) cases were PI-RADs 3, 218 (43.3%) cases were PI-RADs 4, 104 (20.6%) cases were PI-RADs 5. Overall, the Combined Fusion and Standard biopsy detected more csPCA (294, 58.3%) than the systematic (231, 45.8%) or targeted (237, 47.0%) did alone. Isolation of PI-RADS 5 alone showed clinical insignificance in Combined versus Fusion alone. The Standard and Fusion methods are insignificantly different from each other, p-value greater than .05 (.705>.05), across all PI-RADS levels. CONCLUSIONS: Combined Standard and Fusion biopsy was significantly better in the diagnosis of csPCa across PI-RADS 3 to 5. For patients with PI-RADs 5, Combined biopsies were insignificantly different to Fusion. We determined that we could not remove the Standard biopsy from the current technique, though consideration could be given to large volume PI-RADS 5. Standard biopsies still perform well in the detection of csPCA. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e315 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Alex Seabury More articles by this author Yousif Shakroo More articles by this author Dharam M. Ramnani More articles by this author Junqi M. Qian More articles by this author Charles A. Seabury More articles by this author Expand All Advertisement PDF downloadLoading ...