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Comparative Effectiveness of Techniques in Targeted Prostate Biopsy.
Dordaneh Sugano1, Masatomo Kaneko1,2, Wesley Yip1
1USC Institute of Urology and Catherine & Joseph Aresty Department of Urology, Center for Image-Guided and Focal Therapy for Prostate Cancer, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA.
Cancers
|April 3, 2021
Summary
Multiparametric MRI (mpMRI) with targeted biopsy (TB) improves prostate cancer (PCa) detection. While TB is accurate, systematic biopsy (SB) remains crucial for detecting some clinically significant PCa (csPCa).
Area of Science:
- Urology
- Radiology
- Oncology
Background:
- Multiparametric magnetic resonance imaging (mpMRI) has advanced prostate cancer (PCa) detection.
- mpMRI-targeted biopsy (TB) is increasingly used alongside or instead of traditional systematic biopsy (SB).
Purpose of the Study:
- To review and compare different modalities for mpMRI and mpMRI-TB in detecting PCa.
- To evaluate the diagnostic accuracy and clinical utility of various TB techniques.
Main Methods:
- Literature review of studies comparing mpMRI-TB with SB in the same patients.
- Analysis of data comparing transrectal (TR) vs. transperineal (TP) TB approaches.
- Evaluation of cognitive fusion biopsy (COG-TB) and in-bore biopsy (IB-TB) techniques.
Main Results:
- TB shows high accuracy, but SB can detect clinically significant PCa (csPCa) missed by TB.
- Transrectal and transperineal TB approaches demonstrate similar csPCa detection rates.
- COG-TB is operator-dependent with potential accuracy issues for small lesions; IB-TB offers precision but is costly and may miss MRI-invisible lesions.
Conclusions:
- While TB alone is a growing option for efficiency, maintaining SB in the diagnostic pathway is important for comprehensive PCa detection.
- Both TR-TB and TP-TB are viable options for csPCa detection.
- Different TB techniques have unique advantages and limitations that influence their clinical application.
