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Institutional Learning Curve Associated with Implementation of a Magnetic Resonance/Transrectal Ultrasound Fusion
Matthew Truong1, Eric Weinberg2, Gary Hollenberg2
1Department of Urology, University of Rochester School of Medicine and Dentistry, Rochester, New York.
Urology Practice
|June 10, 2023
Summary
Fusion biopsy effectively detects clinically significant prostate cancer in men with prior negative biopsies. Institutional experience and PI-RADS v2 scores are key predictors of successful cancer detection.
Area of Science:
- Urologic Oncology
- Medical Imaging
- Surgical Technology
Background:
- Fusion biopsy adoption involves an institutional learning curve.
- PI-RADS (Prostate Imaging-Reporting and Data System) Version 2 (v2) is utilized for prostate cancer detection.
- Clinically significant prostate cancer is defined as Gleason 7 or greater in men with prior negative biopsies.
Purpose of the Study:
- To assess the institutional learning curve for fusion biopsy using PI-RADS v2.
- To identify patient and technical factors predicting successful detection of clinically significant prostate cancer.
Main Methods:
- 113 consecutive patients with prior negative biopsies underwent fusion biopsy.
- All patients had multiparametric magnetic resonance imaging (mpMRI) with a PI-RADS 3 or greater index lesion.
- Logistic regression analysis identified predictors of clinically significant prostate cancer detection.
Main Results:
- Prostate cancer was detected in 52% of patients; 80% of these had clinically significant cancer.
- Detection rates for clinically significant prostate cancer increased with PI-RADS v2 scores (3: 6%, 4: 46%, 5: 66%).
- Institutional experience, MRI prostate volume, and PI-RADS v2 score independently predicted detection.
Conclusions:
- Fusion biopsy is a technique-dependent procedure.
- Developing internal quality measures is crucial for assessing the institutional learning curve and PI-RADS v2 scoring accuracy.
- This approach is vital for successful adoption of fusion biopsy technology.
