How Many Cores Should Be Collected per Region of Interest in Fusion Targeted Prostate Biopsy? A Retrospective Single...

Area of Science:

• Urology
• Oncology
• Radiology

Background:

• Magnetic resonance imaging-guided (MRI) fusion prostate biopsy enhances detection of clinically significant prostate cancer (csPC).
• Optimal number of biopsy cores per region of interest (ROI) for MRI-guided prostate biopsy remains under investigation.
• Balancing cancer detection with patient comfort and procedural efficiency is crucial.

Purpose of the Study:

• To determine the optimal number of biopsy cores per ROI for MRI-guided prostate biopsy.
• To evaluate the impact of core number on csPC detection rates.
• To compare detection rates between targeted biopsy alone and combined targeted plus systematic biopsy.

Main Methods:

• Retrospective analysis of 483 patients undergoing MRI-guided targeted prostate biopsy (4 cores/ROI) and 12-core systematic biopsy.
• Statistical simulation modeling of 1, 2, 3, or 4 cores per ROI for targeted biopsy.
• Assessment of csPC (grade group ≥2) detection rates for targeted and combined biopsy strategies.

Main Results:

• Targeted biopsy csPC detection rates increased with core number: 21% (1 core), 26% (2 cores), 29% (3 cores), and 31% (4 cores).
• Combined biopsy csPC detection rates showed less variation with core number: 33% (1 core), 35% (2 cores), 37% (3 cores), and 38% (4 cores).
• Two or more targeted cores significantly improved csPC detection compared to one core (P < .05).

Conclusions:

• For MRI-guided targeted prostate biopsy alone, using two or more cores per ROI is superior to one core for detecting csPC.
• The benefit of increasing targeted cores is diminished when combined with a systematic 12-core biopsy.
• The findings suggest optimizing core sampling strategies in prostate biopsy.