Comparing Two Targeted Biopsy Schemes for Detecting Clinically Significant Prostate Cancer in Magnetic Resonance Index Lesions : Two- to Four-Core versus Saturated Transperineal Targeted Biopsy
Morote Robles, Juan (Hospital Universitari Vall d'Hebron)
Paesano, Nahuel (Universitat Autònoma de Barcelona. Departament de Cirurgia)
Picola, Natàlia (Hospital Universitari de Bellvitge)
Miró, Berta (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Abascal, Jose Maria (Parc de Salut MAR de Barcelona)
Servian, Pol (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Trilla Herrera, Enrique (Hospital Universitari Vall d'Hebron)
Méndez Fernández, Olga (Hospital Universitari Vall d'Hebron. Institut de Recerca)

Date:	2024
Abstract:	Targeted biopsies of suspicious lesions detected in magnetic resonance imaging are crucial to discover clinically significant prostate cancer, especially those corresponding to index lesions. However, the optimal scheme for targeted biopsies remains unclear, despite the fact that a two- to four-core scheme is usually recommended. Saturated biopsies of the prostate gland have shown high efficiency in detecting significant PCa. In this article, we report a better efficacy for mapping using a 0. 5 mm core biopsy scheme than that using the two- to four-core scheme for detecting clinically significant prostate cancer in magnetic resonance index lesions. Since the optimal scheme for targeted biopsies of magnetic resonance imaging (MRI) suspicious lesions remains unclear, we compare the efficacy of two schemes for these index lesions. A prospective trial was conducted in 1161 men with Prostate Imaging Reporting and Data System v 2. 1 3-5 undergoing targeted and 12-core systematic biopsy in four centers between 2021 and 2023. Two- to four-core MRI-transrectal ultrasound fusion-targeted biopsies via the transperineal route were conducted in 900 men in three centers, while a mapping per 0. 5 mm core method (saturated scheme) was employed in 261 men biopsied in another center. A propensity-matched 261 paired cases were selected for avoiding confounders other than the targeted biopsy scheme. CsPCa (grade group ≥ 2) was identified in 125 index lesions (41. 1%) when the two- to four-core scheme was employed, while in 187 (71. 9%) when the saturated biopsy (p < 0. 001) was used. Insignificant PCa (iPCa) was detected in 18 and 11. 1%, respectively (p = 0. 019). Rates of csPCa and iPCa remained similar in systematic biopsies. CsPCa detected only in systematic biopsies were 5 and 1. 5%, respectively (p = 0. 035) in each group. The saturated scheme for targeted biopsies detected more csPCa and less iPCa than did the two- to four-core scheme in the index lesions. The rate of csPCa detected only in the systematic biopsies decreased when the saturated scheme was employed.
Grants:	Instituto de Salud Carlos III PI20/01666
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Prostate cancer ; Targeted biopsy ; Index lesion ; Number of cores
Published in:	Cancers, Vol. 16 (june 2024) , ISSN 2072-6694

DOI: 10.3390/cancers16132306
PMID: 39001369

10 p, 1.0 MB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
Articles > Research articles
Articles > Published articles