Do concomitant systematic biopsies add to fusion targeted biopsies in the diagnosis and management of clinically significant prostate cancer?
BAUS ePoster online library. Thompson A. 11/10/20; 304127; P9-10
Alice Thompson
Alice Thompson
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Do concomitant systematic biopsies add to fusion targeted biopsies in the diagnosis and management of clinically significant prostate cancer?

Thompson A1, Eguru V2, Moosa S2, Ng Y2
1Royal Glamorgan Hospital, United Kingdom, 2Prince Philip Hospital, United Kingdom

There is robust evidence that MRI targeted prostate biopsy (TB) has been shown to give a higher diagnostic yield for clinically significant (cs) prostate cancer (PCa) than systematic biopsies (SB). Whether this allows TB to be performed in isolation without concomitant SB remains controversial.

This prospective observational study included all patients undergoing Fusion TB with the aim of comparing TB and SB histology results and impact on clinical outcomes. The primary outcome measure was to ascertain the percentage of csPCa detected on SB missed by TB.

The 104 patients were selected by MDT to have Fusion TB based on bi or multi parametric 1.5T MRI identified PIRAD 3-5 lesions. 18 were biopsy naïve and 85 had previous biopsies. csPCa was defined using PRECISION (Gleason ≥3+4) and PROMIS trial criteria (UCL 1: any primary Gleason 4, or core length ≥6mm).

TB alone missed between 6.25% (2/32)(PRECISION) and 11.1% (4/36)(UCL 1) of csPCa.

Case analysis showed that of the 35 patients offered radical treatment, 2 were based on SB alone and in 4 patients, a radical treatment decision required both biopsies due to upstaging.

TB alone without concomitant SB misses 6.25% to 11.1% of clinically significant prostate cancers in this group of largely previously biopsied patients. Furthermore, in those offered radical treatment, this decision was based, at least in part, on SB in 17.1%. For this reason, we recommend that SB should also be performed at the same time as TB.
Do concomitant systematic biopsies add to fusion targeted biopsies in the diagnosis and management of clinically significant prostate cancer?

Thompson A1, Eguru V2, Moosa S2, Ng Y2
1Royal Glamorgan Hospital, United Kingdom, 2Prince Philip Hospital, United Kingdom

There is robust evidence that MRI targeted prostate biopsy (TB) has been shown to give a higher diagnostic yield for clinically significant (cs) prostate cancer (PCa) than systematic biopsies (SB). Whether this allows TB to be performed in isolation without concomitant SB remains controversial.

This prospective observational study included all patients undergoing Fusion TB with the aim of comparing TB and SB histology results and impact on clinical outcomes. The primary outcome measure was to ascertain the percentage of csPCa detected on SB missed by TB.

The 104 patients were selected by MDT to have Fusion TB based on bi or multi parametric 1.5T MRI identified PIRAD 3-5 lesions. 18 were biopsy naïve and 85 had previous biopsies. csPCa was defined using PRECISION (Gleason ≥3+4) and PROMIS trial criteria (UCL 1: any primary Gleason 4, or core length ≥6mm).

TB alone missed between 6.25% (2/32)(PRECISION) and 11.1% (4/36)(UCL 1) of csPCa.

Case analysis showed that of the 35 patients offered radical treatment, 2 were based on SB alone and in 4 patients, a radical treatment decision required both biopsies due to upstaging.

TB alone without concomitant SB misses 6.25% to 11.1% of clinically significant prostate cancers in this group of largely previously biopsied patients. Furthermore, in those offered radical treatment, this decision was based, at least in part, on SB in 17.1%. For this reason, we recommend that SB should also be performed at the same time as TB.
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