Experiencia de diez años en la transición de biopsias de próstata transrectales a transperineales guiadas por...

We share our 10-year experience with transitioning from MRI-fusion transrectal (TR) to MRI-fusion transperineal (TP) prostate biopsy and the increased costs and time associated with this transition, particularly from the pathology perspective.

Our prospectively maintained MRI-fusion prostate biopsy database was queried. Demographic and clinical data were captured. The cost difference between processing TR and TP biopsies was calculated. Scenarios to decrease cost and time were explored. R-software was used for statistical analyses.

Over 10 years, 2,370 prostate biopsies were performed (1,719 TR, 651 TP). TP biopsy became the preferred method in 2023. The overall cancer detection rates (CDR) and clinically significant CDR (csCDR) for TR biopsy were 55.4% (952/1,719) and 35.4% (609/1,719), respectively. For TP, it was 62.8% (409/651) and 41.8% (272/651), respectively. This was a significant difference in CDR and csCDR (p<0.01). The estimated increased annual cost for TP biopsy from a pathology processing standpoint was $136,662, and the estimated time increase per year was 1,332.5 hours. We constructed 4 scenarios with cost and time reductions as high as $282,750 and 2730 hours per year, respectively.

Transitioning to an MRI-fusion TP prostate biopsy has resulted in higher overall CDR and csCDR rates, but also significantly higher costs and time spent. Possible designs may exist that could yield significant cost and time savings per annum.