Conventional Cognitive Freehand versus Software-Supported, Volumetric-Optimized Systematic Ultrasound-Guided Prostate...

Area of Science:

• Urology
• Oncology
• Medical Imaging

Background:

• Routine systematic prostate biopsy remains crucial for detecting prostate cancer (PCa), complementing targeted biopsies.
• Conventional cognitive freehand (CFT) and volumetric-optimized software-supported (VOT) ultrasound-guided systematic biopsies are compared for PCa detection.

Purpose of the Study:

• To compare the diagnostic performance of VOT versus CFT ultrasound-guided systematic prostate biopsy in detecting significant PCa.
• To assess the relative risk of diagnosing significant PCa using VOT compared to CFT.

Main Methods:

• Retrospective analysis of 573 patients undergoing prostate biopsy between 2014 and 2023.
• Comparison of diagnostic yield and relative risk for PCa detection between CFT (n=135) and VOT (n=438) groups.
• Significant PCa defined as Gleason Score ≥7.

Main Results:

• VOT group showed a higher detection rate of significant PCa (28.5%) compared to the CFT group (18.5%).
• The relative risk for diagnosing significant PCa was significantly higher with VOT (RR 1.54; 95% CI 1.05-2.26).
• Detection rates for insignificant PCa were similar between both methods.

Conclusions:

• VOT demonstrates superior diagnostic performance over CFT for detecting significant PCa.
• Further validation in diverse cohorts is recommended to enhance the generalizability of these findings.