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Related Experiment Video

Updated: Aug 1, 2025

Use of MRI-ultrasound Fusion to Achieve Targeted Prostate Biopsy
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Intra-practice Urologist-level Variation in Targeted Fusion Biopsy Outcomes.

Apoorv Dhir1, Chad S Ellimoottil1, Ji Qi1

  • 1Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI; Dow Division of Health Services Research, Department of Urology, University of Michigan, Ann Arbor, MI.

Urology
|April 30, 2023
PubMed
Summary

Urologist experience did not significantly impact prostate cancer detection rates in fusion biopsies overall. However, variation was observed in detecting clinically significant cancer in PI-RADS 4 lesions, suggesting technique may play a role.

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Area of Science:

  • Urology
  • Oncology
  • Medical Imaging

Background:

  • Fusion-guided prostate biopsy is a key technique for cancer detection.
  • Understanding sources of variation in detection rates is crucial for improving patient outcomes.

Purpose of the Study:

  • To assess the contribution of the performing urologist to detection rate variability in fusion-guided prostate biopsies.
  • To analyze cancer detection rates stratified by PI-RADS score and provider.

Main Methods:

  • Retrospective analysis of 1133 fusion biopsies from the MUSIC registry (August 2017-March 2019).
  • Outcomes included clinically significant cancer detection in targeted cores.
  • Bivariate and multivariable logistic regression analyses were performed, adjusting for multiple patient and lesion factors.

Main Results:

  • No significant difference in overall clinically significant cancer detection rates across 5 providers after adjustment (38.5%-46.9%).
  • Detection rates varied significantly for PI-RADS 4 lesions (adjusted P=.003), but not for PI-RADS 3 or 5 lesions.
  • Specific detection ranges for PI-RADS 3 (11.1%-16.7%), PI-RADS 4 (24.6%-43.4%), and PI-RADS 5 (69.4%-78.8%) were reported.

Conclusions:

  • Urologist-level variation does not significantly impact overall prostate cancer detection in fusion biopsies.
  • A statistically significant difference in detecting clinically significant cancer was found in PI-RADS 4 lesions across providers.
  • Further research is needed to clarify the impact of biopsy technique, radiologist interpretation, and MRI acquisition on detection variability.