Mp49-18 Detection of Clinically Significant Prostate Cancer Using Cognitive Versus Software-Based Mri-Targeting During Transperineal Prostate Biopsy: A Multi-Institutional Analysis

You have accessJournal of UrologyProstate Cancer: Detection & Screening IV (MP49)1 May 2024MP49-18 DETECTION OF CLINICALLY SIGNIFICANT PROSTATE CANCER USING COGNITIVE VERSUS SOFTWARE-BASED MRI-TARGETING DURING TRANSPERINEAL PROSTATE BIOPSY: A MULTI-INSTITUTIONAL ANALYSIS Benjamin Rosenfeld, Dylan M. Buller, William E. Martin, Amanda Sherman, William C. Faust, Serge Ginzburg, Joseph R. Wagner, Alexander Kutikov, Andres F. Correa, Kevin Pinto, Chia-Ling Kuo, Lucas Godoy, Peter C. Albertsen, and Benjamin T. Ristau Benjamin RosenfeldBenjamin Rosenfeld , Dylan M. BullerDylan M. Buller , William E. MartinWilliam E. Martin , Amanda ShermanAmanda Sherman , William C. FaustWilliam C. Faust , Serge GinzburgSerge Ginzburg , Joseph R. WagnerJoseph R. Wagner , Alexander KutikovAlexander Kutikov , Andres F. CorreaAndres F. Correa , Kevin PintoKevin Pinto , Chia-Ling KuoChia-Ling Kuo , Lucas GodoyLucas Godoy , Peter C. AlbertsenPeter C. Albertsen , and Benjamin T. RistauBenjamin T. Ristau View All Author Informationhttps://doi.org/10.1097/01.JU.0001008696.31772.28.18AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: A randomized trial in the transrectal prostate biopsy setting demonstrated no difference in detection of clinically significant prostate cancer (csPC) whether targeted biopsy (TB) of MRI lesions was performed using cognitive or software-based fusion (PMID 30522912). Retrospective data suggests similar lack of difference in the transperineal biopsy (TP-B) setting (PMID 33207137); however, prior analyses have not accounted for the impact of TP-B indication (biopsy naïve (BN), prior negative biopsy (PNB), active surveillance (AS)). We examined a large, multi-institutional cohort of men to assess differences in detection of csPC between cognitive and software-based TB stratified by TP-B indication. METHODS: Prospectively maintained TP-B databases across five institutions were retrospectively analyzed. All patients with PIRADS 3-5 lesions on MRI undergoing TB of the index lesion(s) were included. Baseline demographic and clinical data were captured. Primary outcome was detection of csPC (≥GG2) within a TB stratified by biopsy indication (BN, PNB, and AS) and whether cognitive or software-based fusion was used. Univariate and multivariate statistical analyses were performed. RESULTS: 1,546 TP-B (804 cognitive, 742 software) were included. Median age was 66 y, median PSA 6.9 ng/ml, and median prostate volume 48 cc. 758 were BN, 254 had PNB, and 510 were on AS. Overall csPC detection on TB was 40.9%. On multivariable analysis, there was no significant difference in detection of csPC between cognitive and software-based TB overall (OR 1.15, 95% CI 0.85-1.55, p=0.38). Stratified by biopsy indication, software-based targeting improved detection of csPC in the PNB population (OR 5.02, 95% CI 1.71-16.5, p<0.01). There was no significant difference for BN (OR 0.78, 95% CI 0.52-1.17, p=0.23) or AS (OR 1.59, 95% CI 0.92-2.79, p=0.10). CONCLUSIONS: In a large, multi-institutional cohort undergoing TB of suspicious MRI lesions, we found no significant difference overall in detection of csPC whether a cognitive or software-based technique was used. When stratified by biopsy indication, this lack of difference persisted for BN and AS patients; however, software-based fusion outperformed cognitive fusion in the PNB population. Source of Funding: Unfunded © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e790 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Benjamin Rosenfeld More articles by this author Dylan M. Buller More articles by this author William E. Martin More articles by this author Amanda Sherman More articles by this author William C. Faust More articles by this author Serge Ginzburg More articles by this author Joseph R. Wagner More articles by this author Alexander Kutikov More articles by this author Andres F. Correa More articles by this author Kevin Pinto More articles by this author Chia-Ling Kuo More articles by this author Lucas Godoy More articles by this author Peter C. Albertsen More articles by this author Benjamin T. Ristau More articles by this author Expand All Advertisement PDF downloadLoading ...