Cognitively-targeted, freehand, local anaesthetic trans-perineal prostate biopsies are an inexpensive and highly effective method for sampling targets on MRI: The Altnagelvin Technique
BAUS ePoster online library. Sharma A. 11/10/20; 304226; P9-11 Disclosure(s): Nil
Mr. Abhishek Sharma
Mr. Abhishek Sharma
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Cognitively-targeted, freehand, local anaesthetic trans-perineal prostate biopsies are an inexpensive and highly effective method for sampling targets on MRI: The Altnagelvin Technique

Sharma A1, Subin F1, Mulholland C1
1Altnagelvin Area Hospital

Introduction:
At our centre, we have replaced local-anaesthetic trans-rectal biopsies with local-anaesthetic trans-perineal biopsies for all prostate cancer diagnostics. To our knowledge, our biopsy technique is unique to previously reported literature, in that it does not require proprietary consumable needle-guides nor imaging fusion software to target MRI lesions. Such items can add many £100s in costs per procedure compared to trans-rectal biopsies.
Materials: Data was collected from a prospective, consultant maintained database. Only patients with PI-RADS 3 – 5, who were biopsy naïve were included. Our positive target rate was a surrogate marker of successfully sampling the MRI indicated lesion. Biopsies were trans-perineal, under local anaesthetic, with a co-axial needle in place of a proprietary needle-guide.

Results:
In total 324 TP biopsies were included. The target was positive in 84.5%, negative in 14.2% and indeterminately reported in 1.3%. The average maximum tumour length was 9.6mm indicating that targets were being adequately sampled. Of the positive-target group, 54 were from PI-RADS 4 lesions on MRI. We examined this group separately as these lesions are by definition lesions under 15mm. There were 61 PI-RADS 4 lesions biopsied with a positive target rate of 88.5% (54/61). The average maximum tumour length for these lesions was 7.8mm, once again indicating that the lesions were being adequately sampled.

Conclusion:
Our technique of TP biopsy achieves a high positive rate when combined with MRI targets, and obviates the need for expensive proprietary consumables or fusion-software. Consumable costs per procedure were £10 cheaper than trans-rectal biopsies.
Cognitively-targeted, freehand, local anaesthetic trans-perineal prostate biopsies are an inexpensive and highly effective method for sampling targets on MRI: The Altnagelvin Technique

Sharma A1, Subin F1, Mulholland C1
1Altnagelvin Area Hospital

Introduction:
At our centre, we have replaced local-anaesthetic trans-rectal biopsies with local-anaesthetic trans-perineal biopsies for all prostate cancer diagnostics. To our knowledge, our biopsy technique is unique to previously reported literature, in that it does not require proprietary consumable needle-guides nor imaging fusion software to target MRI lesions. Such items can add many £100s in costs per procedure compared to trans-rectal biopsies.
Materials: Data was collected from a prospective, consultant maintained database. Only patients with PI-RADS 3 – 5, who were biopsy naïve were included. Our positive target rate was a surrogate marker of successfully sampling the MRI indicated lesion. Biopsies were trans-perineal, under local anaesthetic, with a co-axial needle in place of a proprietary needle-guide.

Results:
In total 324 TP biopsies were included. The target was positive in 84.5%, negative in 14.2% and indeterminately reported in 1.3%. The average maximum tumour length was 9.6mm indicating that targets were being adequately sampled. Of the positive-target group, 54 were from PI-RADS 4 lesions on MRI. We examined this group separately as these lesions are by definition lesions under 15mm. There were 61 PI-RADS 4 lesions biopsied with a positive target rate of 88.5% (54/61). The average maximum tumour length for these lesions was 7.8mm, once again indicating that the lesions were being adequately sampled.

Conclusion:
Our technique of TP biopsy achieves a high positive rate when combined with MRI targets, and obviates the need for expensive proprietary consumables or fusion-software. Consumable costs per procedure were £10 cheaper than trans-rectal biopsies.
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