Universität zu Köln

Hansen, Nienke L., Barrett, Tristan, Kesch, Claudia ORCID: 0000-0002-2656-2664, Pepdjonovic, Lana, Bonekamp, David, O'Sullivan, Richard, Distler, Florian, Warren, Anne, Samel, Christina, Hadaschik, Boris ORCID: 0000-0002-1052-2692, Grummet, Jeremy and Kastner, Christof (2018). Multicentre evaluation of magnetic resonance imaging supported transperineal prostate biopsy in biopsy-naive men with suspicion of prostate cancer. BJU Int., 122 (1). S. 40 - 50. HOBOKEN: WILEY. ISSN 1464-410X

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Abstract

ObjectivesTo analyse the detection rates of primary magnetic resonance imaging (MRI)-fusion transperineal prostate biopsy using combined targeted and systematic core distribution in three tertiary referral centres. Patients and MethodsIn this multicentre, prospective outcome study, 807 consecutive biopsy-naive patients underwent MRI-guided transperineal prostate biopsy, as the first diagnostic intervention, between 10/2012 and 05/2016. MRI was reported following the Prostate Imaging-Reporting and Data System (PI-RADS) criteria. In all, 236 patients had 18-24 systematic transperineal biopsies only, and 571 patients underwent additional targeted biopsies either by MRI-fusion or cognitive targeting if PI-RADS 3 lesions were present. Detection rates for any and Gleason score 7-10 cancer in targeted and overall biopsy were calculated and predictive values were calculated for different PI-RADS and PSA density (PSAD) groups. ResultsCancer was detected in 68% of the patients (546/807) and Gleason score 7-10 cancer in 49% (392/807). The negative predictive value of 236 PI-RADS 1-2 MRI in combination with PSAD of <0.1ng/mL/mL for Gleason score 7-10 was 0.91 (95% confidence interval 0.07, 8% of study population). In 418 patients with PI-RADS 4-5 lesions using targeted plus systematic biopsies, the cancer detection rate of Gleason score 7-10 was significantly higher at 71% vs 59% and 61% with either approach alone (P < 0.001). For 153 PI-RADS 3 lesions, the detection rate was 31% with no significant difference to systematic biopsies with 27% (P > 0.05). Limitations include variability of multiparametric MRI (mpMRI) reading and Gleason grading. ConclusionMRI-based transperineal biopsy performed at high-volume tertiary care centres with a significant experience of prostate mpMRI and image-guided targeted biopsies yielded high detection rates of Gleason score 7-10 cancer. Prostate biopsies may not be needed for men with low PSAD and an unsuspicious MRI. In patients with high probability lesions, combined targeted and systematic biopsies are recommended.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Hansen, Nienke L. UNSPECIFIED UNSPECIFIED UNSPECIFIED Barrett, Tristan UNSPECIFIED UNSPECIFIED UNSPECIFIED Kesch, Claudia UNSPECIFIED orcid.org/0000-0002-2656-2664 UNSPECIFIED Pepdjonovic, Lana UNSPECIFIED UNSPECIFIED UNSPECIFIED Bonekamp, David UNSPECIFIED UNSPECIFIED UNSPECIFIED O'Sullivan, Richard UNSPECIFIED UNSPECIFIED UNSPECIFIED Distler, Florian UNSPECIFIED UNSPECIFIED UNSPECIFIED Warren, Anne UNSPECIFIED UNSPECIFIED UNSPECIFIED Samel, Christina UNSPECIFIED UNSPECIFIED UNSPECIFIED Hadaschik, Boris UNSPECIFIED orcid.org/0000-0002-1052-2692 UNSPECIFIED Grummet, Jeremy UNSPECIFIED UNSPECIFIED UNSPECIFIED Kastner, Christof UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-181435
DOI:	10.1111/bju.14049
Journal or Publication Title:	BJU Int.
Volume:	122
Number:	1
Page Range:	S. 40 - 50
Date:	2018
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	1464-410X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ULTRASOUND-GUIDED BIOPSY; TARGETED BIOPSY; REPEAT BIOPSY; FUSION; MRI; GUIDELINES; DIAGNOSIS; RISK; HISTOPATHOLOGY; LESIONS Multiple languages Urology & Nephrology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/18143