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TOP: Prospective Evaluation of a Volume Based, Computer Assisted Method for Transperineal Optimized Prostate Biopsy
Claudia Kesch1, Jan Philipp Radtke, Ionel Valentin Popeneciu
1Department of Urology, University Hospital Heidelberg, Heidelberg, Germany.
Urologia Internationalis
|March 28, 2017
Summary
The transperineal optimized prostate (TOP) biopsy method significantly improves prostate cancer detection compared to MRI-targeted biopsies alone. This computer-assisted technique identifies more significant tumors but also detects more low-risk cancers.
Area of Science:
- Urology
- Medical Imaging
- Oncology
Background:
- Prostate cancer diagnosis relies on accurate biopsy techniques.
- Current methods may miss clinically significant tumors or over-detect low-risk disease.
Purpose of the Study:
- To prospectively evaluate a computer-assisted, volume-based method for transperineal optimized prostate (TOP) biopsy.
- To assess the efficacy of the TOP algorithm in automating systematic prostate biopsy planning.
Main Methods:
- Prospective evaluation of 172 men undergoing MRI-transrectal ultrasound fusion biopsy.
- Comparison of MRI-targeted biopsies (TBs) with systematic TOP biopsies.
- TOP algorithm used for core planning, considering tumor volume exclusion and organ coverage.
Main Results:
- TOP biopsies detected 97% of all prostate cancer (PCa) and 97% of significant PCa (Gleason score ≥7).
- MRI-targeted biopsies detected 55% of all PCa and 68% of significant PCa.
- Systematic-TOP sampling significantly outperformed TB for detecting both all and significant PCa (p < 0.0001).
Conclusions:
- The TOP method integrates individual prostate and PCa volume thresholds for optimized biopsy planning.
- TOP diagnosed more significant tumors than TB alone in this cohort.
- The TOP method also led to the detection of more low-risk tumors.
