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Clinical, Imaging, and Technical Factors Associated with Successful Genomic Profiling of Bone Biopsy Tissue in

Fourat Ridouani1, H Alberto Vargas2, Daniel J Holzwanger3

  • 1Department of Radiology, Interventional Radiology Division, Memorial Sloan Kettering Cancer, New York, NY, USA.

European Urology Oncology
|August 2, 2024
PubMed
Abstract

Insights

Successful genomic profiling of metastatic castration-resistant prostate cancer (mCRPC) bone biopsies depends on selecting sites with high metabolic activity and lower CT attenuation. This improves the chances of obtaining sufficient tumor material for large-panel DNA sequencing and personalized treatment.

Area of Science:

  • Oncology
  • Genomics
  • Medical Imaging

Background:

  • Genomic profiling of metastatic castration-resistant prostate cancer (mCRPC) often relies on osseous metastases.
  • Tissue acquisition for genomic analysis from bone lesions presents challenges.
  • Optimizing biopsy site selection and technique is crucial for identifying actionable mutations.

Purpose of the Study:

  • To identify key parameters influencing successful large-panel DNA sequencing from bone biopsies in mCRPC patients.
  • To guide clinical decision-making for metastatic site selection and biopsy techniques.

Main Methods:

  • Analysis of 269 bone biopsies from 243 men with mCRPC between 2014 and 2018.
  • Evaluation of clinical, imaging (bone scan, FDG-PET, CT, MRI), and technical biopsy parameters.
  • Univariate and multivariate statistical analyses to determine associations with successful genomic profiling.

Main Results:

  • 59% of biopsies yielded sufficient tumor material for genomic profiling.
  • Multivariate analysis identified higher FDG maximum standardized uptake value (OR 7.51), more biopsy samples (OR 4.73), and lower mean CT attenuation (OR 0.4) as significant predictors of sequencing success.
  • FDG-PET positivity, CT attenuation, and CT morphology were significant on univariate analysis.

Conclusions:

  • Bone biopsies from sites with high metabolic activity (FDG-PET positive) and lower CT attenuation are associated with higher success rates for genomic profiling.
  • Increasing the number of biopsy samples also improves the likelihood of successful sequencing.
  • These findings aid in selecting optimal biopsy sites and techniques for personalized mCRPC treatment planning.
Keywords:
Bone biopsyFlurodeoxyglucoseGenomic profilingImagingPositron emission tomographyProstate cancer

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