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Enhancing Prostate Tumor Biobanking Reliability with Improved Sampling Technique and Histological Characterization

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Effectiveness of Mapping for Cognitive Prostate Biopsy: A Prospective, Randomized Study.

Murat Kars¹, Canan Cimsit², Yunus Emre Genc¹

¹Department of Urology, School of Medicine, Marmara University, Istanbul, Turkey.

|March 24, 2025

Summary

Adding a prostate mapping diagram to multiparametric MRI reports significantly improves prostate cancer detection rates. This simple strategy enhances diagnostic accuracy for clinically significant prostate cancer using cognitive biopsy.

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Area of Science:

Urology
Radiology
Oncology

Background:

Cognitive prostate biopsy is preferred for its cost-effectiveness but lacks standardization.
Operator dependency in cognitive biopsy can reduce diagnostic accuracy for prostate cancer (PCa).

Purpose of the Study:

To assess the efficacy of incorporating a prostate mapping diagram into multiparametric MRI (mpMRI) reports.
To improve diagnostic accuracy for PCa through standardized biopsy targeting.

Main Methods:

A randomized prospective study involving 155 patients undergoing mpMRI.
Patients were assigned to either a standard group or a group receiving mpMRI reports with a prostate mapping diagram.
Targeted biopsies of suspicious lesions (≥PI-RADS 3) were performed, alongside systematic biopsies.

Main Results:

The cancer detection rate was significantly higher in the mapping group (57%) compared to the standard group (35%).
Clinically significant PCa (csPCa) detection rates were 47% in the mapping group versus 21% in the standard group.
Targeted biopsies alone showed a 3-fold increase in csPCa detection in the mapping group.

Conclusions:

A simple prostate mapping diagram integrated into mpMRI reports significantly enhances prostate cancer detection rates.
This schematic mapping strategy improves diagnostic accuracy, particularly for csPCa, when used with cognitive biopsy.
The study recommends adopting schematic mapping diagrams in biopsy protocols to standardize and improve PCa diagnosis.