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Abdominal Radiology

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31.07.2020 | Special Section: Prostate cancer update

Comparison of biopsy strategies for prostate biopsy according to lesion size and PSA density in MRI-directed biopsy pathway

verfasst von: Mi Yeon Park, Kye Jin Park, Bumjin Lim, Mi-hyun Kim, In Gab Jeong, Jeong Kon Kim

Erschienen in: Abdominal Radiology | Ausgabe 12/2020

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Abstract

Purpose

To investigate whether the detection of clinically significant prostate cancer (csPCa) and the added value of focal saturation biopsy and systematic biopsy (SBx) differ according to index lesion size, and to compare the current guidelines for csPCa detection.

Methods

This retrospective study included consecutive men who underwent MRI and subsequent SBx and MRI-targeted biopsy (TBx) for a suspicious lesion between April 2019 and February 2020. Lesion visibility on transrectal ultrasound (US) and added value of focal saturation biopsy and SBx were compared according to index lesion size using chi-square and McNemar tests. csPCa detection rates and the proportion of biopsy-indicated men were compared among four biopsy strategies based on current guidelines.

Results

Of 313 men evaluated (median age, 65; interquartile range 60‒71), csPCa was detected in 110 (35%). In lesions < 10 mm, greater US invisibility (42.7% of lesions < 10 mm versus 20.0% of lesions ≥ 10 mm; p < 0.001) and higher added value of focal saturation biopsy and SBx (11.1% and 17.1% in lesions < 10 mm versus 4.2% and 6.3% in lesions ≥ 10 mm) were observed, compared with lesions ≥ 10 mm. Consideration of prostate-specific antigen (PSA) density > 0.15 ng/mL/mL as a cutoff in unsuspicious MRI led to a 14% reduction (44/313) in men who needed biopsy.

Conclusion

Determination of the biopsy strategy in terms of the need for focal saturation biopsy or SBx should be made considering lesion size. The use of PSA density in non-suspicious MRI can lead to a reduction in biopsy-indicated men.

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Titel: Comparison of biopsy strategies for prostate biopsy according to lesion size and PSA density in MRI-directed biopsy pathway
verfasst von: Mi Yeon Park
Kye Jin Park
Bumjin Lim
Mi-hyun Kim
In Gab Jeong
Jeong Kon Kim
Publikationsdatum: 31.07.2020
Verlag: Springer US
Erschienen in: Abdominal Radiology / Ausgabe 12/2020
Print ISSN: 2366-004X
Elektronische ISSN: 2366-0058
DOI: https://doi.org/10.1007/s00261-020-02667-4

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Comparison of biopsy strategies for prostate biopsy according to lesion size and PSA density in MRI-directed biopsy pathway

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