d38b2e6e4a9445a178123510c8665ac0 cancers-15-04543.pdf d6804f5f42e002b359dde038ce43990eefdcfed4 cancers-15-04543.pdf 6f3e9ae9c4c544a0fa0f4913e0a8c07da5292d9a484392665087fb9755e519e8 cancers-15-04543.pdf Title: A Diagnostic Accuracy Study of Targeted and Systematic Biopsies to Detect Clinically Significant Prostate Cancer, including a Model for the Partial Omission of Systematic Biopsies Subject: The primary objective of this study was to analyse the current accuracy of targeted and systematic prostate biopsies in detecting csPCa. A secondary objective was to determine whether there are factors predicting the finding of csPCa in targeted biopsies and, if so, to explore the utility of a predictive model for csPCa detection only in targeted biopsies. We analysed 2122 men with suspected PCa, serum PSA > 3 ng/mL, and/or a suspicious digital rectal examination (DRE), who underwent targeted and systematic biopsies between 2021 and 2022. CsPCa (grade group 2 or higher) was detected in 1026 men (48.4%). Discrepancies in csPCa detection in targeted and systematic biopsies were observed in 49.6%, with 13.9% of csPCa cases being detected only in systematic biopsies and 35.7% only in targeted biopsies. A predictive model for csPCa detection only in targeted biopsies was developed from the independent predictors age (years), prostate volume (mL), PI-RADS score (3 to 5), mpMRI Tesla (1.5 vs. 3.0), TRUS-MRI fusion image technique (cognitive vs. software), and prostate biopsy route (transrectal vs. transperineal). The csPCa discrimination ability of targeted biopsies showed an AUC of 0.741 (95% CI 0.721–0.762). The avoidance rate of systematic prostate biopsies went from 0.5% without missing csPCa to 18.3% missing 4.6% of csPCa cases. We conclude that the csPCa diagnostic accuracy of targeted biopsies is higher than that of systematic biopsies. However, a significant rate of csPCa remains detected only in systematic biopsies. A predictive model for the partial omission of systematic biopsies was developed. Keywords: clinically significant prostate cancer detection; systematic biopsy; targeted biopsy; prostate biopsy concordance Author: Juan Morote, Natàlia Picola, Jesús Muñoz-Rodriguez, Nahuel Paesano, Xavier Ruiz-Plazas, Marta V. Muñoz-Rivero, Anna Celma, Gemma García-de Manuel, Ignacio Aisian, Pol Servian and José M. Abascal Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Wed Sep 13 12:35:49 2023 CEST ModDate: Wed Sep 13 12:46:45 2023 CEST Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 12 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 611813 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- BFMXMV+VnURWPalladioL Type 1 Custom yes yes no 10 0 RUDYYF+URWPalladioL-Bold Type 1 Custom yes yes no 15 0 MZFJCF+URWPalladioL-Roma Type 1 Custom yes yes no 20 0 NLPRAB+URWPalladioL-Ital Type 1 Custom yes yes no 24 0 ICWMHX+VnURWPalladioL-Bold Type 1 Custom yes yes no 28 0 LCJEVJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 47 0 CNXSVA+CMSY10 Type 1 Builtin yes yes no 72 0 WBVKDJ+URWPalladioL-BoldItal Type 1 Custom yes yes no 82 0 PIBJOB+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 99 0 PIBJOD+PalatinoLinotype TrueType WinAnsi yes yes no 102 0 PIBJOF+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 105 0 PIBKID+PalatinoLinotype TrueType MacRoman yes yes no 108 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2024-02-10 02:33:14 CET RepresentationInformation: cancers-15-04543.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2024-02-09 18:55:45 CET Size: 611813 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 263 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Materials and Methods Destination: section.2 Children: Item: Title: Design, Setting, and Participants Destination: subsection.2.1 Item: Title: MRI and Prostate Biopsy Destination: subsection.2.2 Item: Title: Outcome Variable Destination: subsection.2.3 Item: Title: Candidate Predictive Variables for the Concordance Degree of csPCa Detection between Systematic and Targeted Biopsies Destination: subsection.2.4 Item: Title: Statistical Analysis Destination: subsection.2.5 Item: Title: Results Destination: section.3 Children: Item: Title: Characteristics of the Study Cohort Destination: subsection.3.1 Item: Title: Analysis of Concordance between Systematic and Targeted Biopsies according to the Detection of csPCa Destination: subsection.3.2 Item: Title: Univariate and Multivariate Analyses of Candidate Predictive Variables for the Concordance Degree of csPCa in Systematic and Targeted Biopsies Destination: subsection.3.3 Item: Title: Development of a Predictive Model for the Discrimination Ability of Targeted Biopsies to Detect csPCa Destination: subsection.3.4 Item: Title: Discussion Destination: section.4 Item: Title: Conclusions Destination: section.5 Item: Title: References Destination: section.6 Info: Title: A Diagnostic Accuracy Study of Targeted and Systematic Biopsies to Detect Clinically Significant Prostate Cancer, including a Model for the Partial Omission of Systematic Biopsies Author: Juan Morote, Natàlia Picola, Jesús Muñoz-Rodriguez, Nahuel Paesano, Xavier Ruiz-Plazas, Marta V. Muñoz-Rivero, Anna Celma, Gemma García-de Manuel, Ignacio Aisian, Pol Servian and José M. Abascal Subject: The primary objective of this study was to analyse the current accuracy of targeted and systematic prostate biopsies in detecting csPCa. A secondary objective was to determine whether there are factors predicting the finding of csPCa in targeted biopsies and, if so, to explore the utility of a predictive model for csPCa detection only in targeted biopsies. We analysed 2122 men with suspected PCa, serum PSA > 3 ng/mL, and/or a suspicious digital rectal examination (DRE), who underwent targeted and systematic biopsies between 2021 and 2022. CsPCa (grade group 2 or higher) was detected in 1026 men (48.4%). Discrepancies in csPCa detection in targeted and systematic biopsies were observed in 49.6%, with 13.9% of csPCa cases being detected only in systematic biopsies and 35.7% only in targeted biopsies. A predictive model for csPCa detection only in targeted biopsies was developed from the independent predictors age (years), prostate volume (mL), PI-RADS score (3 to 5), mpMRI Tesla (1.5 vs. 3.0), TRUS-MRI fusion image technique (cognitive vs. software), and prostate biopsy route (transrectal vs. transperineal). The csPCa discrimination ability of targeted biopsies showed an AUC of 0.741 (95% CI 0.721 0.762). The avoidance rate of systematic prostate biopsies went from 0.5% without missing csPCa to 18.3% missing 4.6% of csPCa cases. We conclude that the csPCa diagnostic accuracy of targeted biopsies is higher than that of systematic biopsies. However, a significant rate of csPCa remains detected only in systematic biopsies. A predictive model for the partial omission of systematic biopsies was developed. 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