Mp19-06 Prospective Evaluation of the Learning Curve for Transperineal Mri/Trus Fusion-Guided Prostate Biopsy

You have accessJournal of UrologyProstate Cancer: Detection & Screening I (MP19)1 May 2024MP19-06 PROSPECTIVE EVALUATION OF THE LEARNING CURVE FOR TRANSPERINEAL MRI/TRUS FUSION-GUIDED PROSTATE BIOPSY Masatomo Kaneko, Lorenzo Storino Ramacciotti, Divyangi Paralkar, Donya S. Jadvar, Giovanni E. Cacciamani, Mihir Desai, Monish Aron, Manju Aron, Michelle Hopstone, Inderbir S. Gill, and Andre Luis Abreu Masatomo KanekoMasatomo Kaneko , Lorenzo Storino RamacciottiLorenzo Storino Ramacciotti , Divyangi ParalkarDivyangi Paralkar , Donya S. JadvarDonya S. Jadvar , Giovanni E. CacciamaniGiovanni E. Cacciamani , Mihir DesaiMihir Desai , Monish AronMonish Aron , Manju AronManju Aron , Michelle HopstoneMichelle Hopstone , Inderbir S. GillInderbir S. Gill , and Andre Luis AbreuAndre Luis Abreu View All Author Informationhttps://doi.org/10.1097/01.JU.0001008716.22569.77.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: To determine the learning curve of transperineal (TP) magnetic resonance imaging (MRI) and transrectal ultrasound (TRUS) fusion prostate biopsy (PBx). METHODS: Consecutive men who underwent MRI followed by TP PBx were prospectively enrolled (IRB# HS-13-00663) and divided into five chronological quintiles. All patients underwent MRI followed by 12-14 core systematic biopsy (SB). A minimum of additional two targeted biopsy (TB) cores were taken per PIRADS ≥3. TP MRI/TRUS fusion biopsy was performed using an image fusion system (Koelis, TRINITY). The 1st quintile underwent TP PBx under sedation, and the 2nd to 5th quintiles under local anesthesia. The inflection point analysis was used to determine the number of cases to reach proficiency levels for operative time. Clinically significant PCa (CSPCa) if Grade Group ³ 2. Statistically significant if p<0.05. RESULTS: A total of 370 patients met the inclusion criteria and were divided into quintiles of 74 men each. The CSPCa detection rates on SB+TB weren't different across the quintiles: PIRADS 1-5 (35-50%; p=0.27); PIRADS 1-2 (0-18%; p=0.25); PIRADS 3-5 groups (46-70%; p=0.12). Similar was found on TB alone (41-66%; p=0.08) (Figure 1). Age, PSA density, PIRADS 3-5, and number of core biopsy were independent predictors for CSPCa detection; however, chronological quintiles were not an independent predictor. The operative time significantly decreased from the 1st to 5th quintiles (45 min to 19 min; p<0.01), reaching a plateau after 147 cases. This was consistent across PIRADS 1-2 (33 min to 13 min; p<0.01) and PIRADS 3-5 groups (48 min to 19 min; p<0.01). The independent predictors for longer operative time were the number of MRI lesions and the earlier quintile. The median patients' self-assessed pain (visual analog scale 0-10) immediately after PBx was not significantly different from the 2nd to 5th quintiles (4, 3, 3, and 3; p=0.14). Complications were also similar between the quintiles (2.7%, 0%, 1.4%, 1.4%, and 1.4%; p=0.7). CONCLUSIONS: The CSPCa detection is adequate from the beginning of learning for TP MRI/TRUS fusion biopsy. However, the operative time significantly improved demonstrating proficiency after 147 cases. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e312 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Masatomo Kaneko More articles by this author Lorenzo Storino Ramacciotti More articles by this author Divyangi Paralkar More articles by this author Donya S. Jadvar More articles by this author Giovanni E. Cacciamani More articles by this author Mihir Desai More articles by this author Monish Aron More articles by this author Manju Aron More articles by this author Michelle Hopstone More articles by this author Inderbir S. Gill More articles by this author Andre Luis Abreu More articles by this author Expand All Advertisement PDF downloadLoading ...