Русский
Prospective comparison of cognitive and mpMR/US fusion biopsy for prostate cancer detection
DOI: https://dx.doi.org/10.18565/urology.2022.4.38-43
V.S. Petov , A.K. Bazarkin, A.O. Morozov, M.S. Taratkin, T.M. Ganzha, S.P. Danilov, Y.N. Chernov, D.V. Chinenov, A.V. Amosov, D.V. Enikeev, G.E. Krupinov
1) Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia; 2) Institute for clinical medicine named after N.V. Sklifosovsky, Sechenov University, Moscow, Russia
Introduction. According to the recommendations of the European Association of Urology the presence of a suspicious lesion on MRI is an indication for both primary and secondary MR-targeted biopsies. At the same time, the Russian Society of Urologists recommends to perform mpMR/US fusion biopsy only in patients with a prior negative biopsy. In clinical practice, mpMR/US fusion and cognitive biopsies are the most frequently performed. However, when comparing them, contradictory data on detection of clinically significant prostate cancer is obtained.
Objective to compare the detection rate of clinically significant prostate cancer performing cognitive and mpMR/US fusion biopsies.
Materials and Methods. Inclusion criteria: PSA >2 ng/mL and/or a positive DRE, and/or a suspicious lesion on TRUS, and PI-RADSv2.1 lesion ≥3. At first, «unblinded» urologist performed a transperineal mpMR/ultrasound fusion and saturation biopsy. Then “blinded” urologist obtained transrectal cognitive biopsy Clinically significant cancer was defined as ISUP ≥2.
Results. We enrolled 96 patients. Median age was 63 years, prostate volume – 47 cm3 and PSA – 6.82 ng/mL. MpMR/US fusion and cognitive biopsies were comparable in regard to the detection rate of clinically significant (32.3% vs 25.0%; p=0.264), clinically insignificant cancer (25.0% and 26.0%; p=0.869) and overall detection rate (57.3% and 51%;p=0.385). Both biopsies missed clinically significant cancer with equal frequency (5.2%; p=0.839). Histological efficacy also was comparable. The number of positive cores between mpMR/US fusion and cognitive biopsy was equal (34.1% and 31.1% respectively; p= 0.415). At the same time, no statistically significant difference was found with respect to maximum cancer core length (53.1% vs 47.7%, respectively; p=0.293).
Conclusion. The results suggest that both cognitive and mpMR/US fusion biopsies are equally accurate diagnostic methods for clinically significant prostate cancer detection, thus their wider introduction into clinical practice is necessary.
Objective to compare the detection rate of clinically significant prostate cancer performing cognitive and mpMR/US fusion biopsies.
Materials and Methods. Inclusion criteria: PSA >2 ng/mL and/or a positive DRE, and/or a suspicious lesion on TRUS, and PI-RADSv2.1 lesion ≥3. At first, «unblinded» urologist performed a transperineal mpMR/ultrasound fusion and saturation biopsy. Then “blinded” urologist obtained transrectal cognitive biopsy Clinically significant cancer was defined as ISUP ≥2.
Results. We enrolled 96 patients. Median age was 63 years, prostate volume – 47 cm3 and PSA – 6.82 ng/mL. MpMR/US fusion and cognitive biopsies were comparable in regard to the detection rate of clinically significant (32.3% vs 25.0%; p=0.264), clinically insignificant cancer (25.0% and 26.0%; p=0.869) and overall detection rate (57.3% and 51%;p=0.385). Both biopsies missed clinically significant cancer with equal frequency (5.2%; p=0.839). Histological efficacy also was comparable. The number of positive cores between mpMR/US fusion and cognitive biopsy was equal (34.1% and 31.1% respectively; p= 0.415). At the same time, no statistically significant difference was found with respect to maximum cancer core length (53.1% vs 47.7%, respectively; p=0.293).
Conclusion. The results suggest that both cognitive and mpMR/US fusion biopsies are equally accurate diagnostic methods for clinically significant prostate cancer detection, thus their wider introduction into clinical practice is necessary.
About the Autors
For correspondence: V.S. Petov – M.D., researcher Institute for Urology and Reproductive Health, Sechenov University; e-mail: pettow@mail.com
