Clinical utility of non-targeted systematic prostate biopsies in patients undergoing pre-biopsy mpMRI from a multicentre series of 2,350 patients
BAUS ePoster online library. Connor M. 11/10/20; 304202; P9-9
Mr. Martin John Connor
Mr. Martin John Connor
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Clinical utility of non-targeted systematic prostate biopsies in patients undergoing pre-biopsy mpMRI from a multicentre series of 2,350 patients

Connor M1, Eldred-Evans D1, Bertoncelli Tanaka M1,2, Reddy D1, Bass E1, Hoskings-Jervis F1, Bhola-Stewart H2, Powell L3, Natarajan M3, Lee J3, Sri D3, Ahmad S4, Jochi S5, Pegers E5, Patel A6, Sahadevan K6, Wong K4, Tam H2, Hrouda D2, Winkler M2, McCracken S6, Gordon S4, Qazi H3, Ahmed H1,2
1Imperial College London, United Kingdom, 2Imperial College Healthcare NHS Trust, London, United Kingdom, 3St. George's University Hospitals NHS Foundation Trust, London, United Kingdom, 4Epsom and St Helier University Hospital, London, United Kingdom, 5RM Partners: West London Cancer Alliance, United Kingdom, 6Sunderland Royal Hospital, London, United Kingdom

Introduction:
The diagnostic yield of clinically significant prostate cancer (csPCa) in non-targeted biopsies in men with a suspicious multi-parametric (mpMRI) remains unclear. The aim of this study was to determine the clinical utility of non-targeted prostate biopsies when performed alongside MRI-targeted biopsies across multiple centres using pre-biopsy mpMRI in men referred with a suspicion of prostate cancer.

Patients and Methods:
A prospective online biopsy registry of 2,350 consecutive patients (Apr/2017-Dec/2019). Transperineal biopsy was advised if PI-RADS score was 4-5 or score 3 with PSA-density >/=0.12. csPCa was defined as Gleason >/=3+4.

Results:
Mean age, median PSA and median prostate volume were 65.8 yrs (SD 8.4), of 6.7 (IQR 4.8 - 9.9) ng/ml and 49cc (IQR 35-72). 1,148 (48.6%) underwent biopsy with csPCa in 631/1148 (54.9%). 848 underwent combined targeted and non-targeted systematic biopsies. In men without cancer in targeted biopsy, 22/848 (2.6%) had csPCa in non-targeted and 37/848 (4.3%) Gleason 3+3 disease alone. No Gleason >4+3 was detected in exclusively non-targeted biopsies. When csPCa was detected in targeted-biopsies, csPCa was also present in 150/848 (17.7%) of non-targeted biopsies with only Gleason 3+3 present in 53/848 (6.3%) of non-targeted biopsies in this group. In 69 men with only Gleason 3+3 in targeted biopsies, csPCa was present in non-targeted areas in 9.

Conclusion:
Detection of csPCa in only non-targeted systematic biopsies in a pre-biopsy mpMRI pathway is 2.6% although when csPCa is found in targeted biopsies, this rate is higher.
Clinical utility of non-targeted systematic prostate biopsies in patients undergoing pre-biopsy mpMRI from a multicentre series of 2,350 patients

Connor M1, Eldred-Evans D1, Bertoncelli Tanaka M1,2, Reddy D1, Bass E1, Hoskings-Jervis F1, Bhola-Stewart H2, Powell L3, Natarajan M3, Lee J3, Sri D3, Ahmad S4, Jochi S5, Pegers E5, Patel A6, Sahadevan K6, Wong K4, Tam H2, Hrouda D2, Winkler M2, McCracken S6, Gordon S4, Qazi H3, Ahmed H1,2
1Imperial College London, United Kingdom, 2Imperial College Healthcare NHS Trust, London, United Kingdom, 3St. George's University Hospitals NHS Foundation Trust, London, United Kingdom, 4Epsom and St Helier University Hospital, London, United Kingdom, 5RM Partners: West London Cancer Alliance, United Kingdom, 6Sunderland Royal Hospital, London, United Kingdom

Introduction:
The diagnostic yield of clinically significant prostate cancer (csPCa) in non-targeted biopsies in men with a suspicious multi-parametric (mpMRI) remains unclear. The aim of this study was to determine the clinical utility of non-targeted prostate biopsies when performed alongside MRI-targeted biopsies across multiple centres using pre-biopsy mpMRI in men referred with a suspicion of prostate cancer.

Patients and Methods:
A prospective online biopsy registry of 2,350 consecutive patients (Apr/2017-Dec/2019). Transperineal biopsy was advised if PI-RADS score was 4-5 or score 3 with PSA-density >/=0.12. csPCa was defined as Gleason >/=3+4.

Results:
Mean age, median PSA and median prostate volume were 65.8 yrs (SD 8.4), of 6.7 (IQR 4.8 - 9.9) ng/ml and 49cc (IQR 35-72). 1,148 (48.6%) underwent biopsy with csPCa in 631/1148 (54.9%). 848 underwent combined targeted and non-targeted systematic biopsies. In men without cancer in targeted biopsy, 22/848 (2.6%) had csPCa in non-targeted and 37/848 (4.3%) Gleason 3+3 disease alone. No Gleason >4+3 was detected in exclusively non-targeted biopsies. When csPCa was detected in targeted-biopsies, csPCa was also present in 150/848 (17.7%) of non-targeted biopsies with only Gleason 3+3 present in 53/848 (6.3%) of non-targeted biopsies in this group. In 69 men with only Gleason 3+3 in targeted biopsies, csPCa was present in non-targeted areas in 9.

Conclusion:
Detection of csPCa in only non-targeted systematic biopsies in a pre-biopsy mpMRI pathway is 2.6% although when csPCa is found in targeted biopsies, this rate is higher.
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