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Use of Magnetic Resonance Imaging and Biopsy Data to Guide Sampling Procedures for Prostate Cancer Biobanking
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Repeat Prostate Biopsy Practice Patterns in a Statewide Quality Improvement Collaborative.

Frank N Burks1, Jonathan C Hu1, Dinesh Telang1

  • 1Department of Urology, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan; Department of Urology, University of Michigan (AL, SH, ZM, SL, JEM, DCM, KRG), Ann Arbor, Michigan.

The Journal of Urology
|March 5, 2017
PubMed
Summary
This summary is machine-generated.

Repeat prostate biopsies are underutilized, especially for high-grade prostatic intraepithelial neoplasia (HGPIN) and atypical small acinar proliferation (ASAP). Targeted quality improvement can increase cancer detection rates in these patients.

Keywords:
biopsydiagnosisprostatic intraepithelial neoplasiaprostatic neoplasmsquality improvement

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Area of Science:

  • Urology
  • Oncology
  • Pathology

Background:

  • Guidelines recommend repeat prostate biopsy for specific findings like high-grade prostatic intraepithelial neoplasia (HGPIN) and atypical small acinar proliferation (ASAP).
  • Adherence to these guidelines is crucial for timely prostate cancer diagnosis.

Purpose of the Study:

  • To evaluate adherence to repeat prostate biopsy guidelines within the Michigan Urological Surgery Improvement Collaborative (MUSIC).
  • To assess rebiopsy rates and cancer detection following initial prostate biopsies showing HGPIN or ASAP.

Main Methods:

  • Analysis of data from the MUSIC registry on men undergoing repeat prostate biopsies.
  • Multivariate regression modeling to determine rebiopsy proportions and claims data for treatment validation.
  • Chart review of a sample of patients with ASAP to identify reasons for non-rebiopsy.

Main Results:

  • Only 7.6% of men with negative initial biopsies underwent rebiopsy. Rebiopsy rates for HGPIN and ASAP varied significantly (20.7% to 55.6%).
  • The overall cancer detection rate at rebiopsy was 39.3%, highest in patients with ASAP (adjusted probability 0.39).
  • Reasons for not rebiasing included PSA testing (45.5% for ASAP) and failure to follow recommendations (36%).

Conclusions:

  • Rebiopsy rates for HGPIN and ASAP are low and vary across practices.
  • Quality improvement initiatives should focus on patients with ASAP and HGPIN due to their high cancer detection potential at rebiopsy.