Comparing cognitive-targeted versus fusion-guided and template-guided prostate biopsy modalities according to Prostate Imaging Reporting and Data System version 2 stratification for the detection of clinically significant prostate cancer
BAUS ePoster online library. Desai C. 06/21/21; 318996; p1-8
Disclosure(s): Nil to disclose.
Dr. Chaitya Desai
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Abstract
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Introduction
European Association of Urology recommends multiparametric magnetic resonance imaging (mpMRI) of the prostate, combined with standardised reporting using the Prostate Imaging and Data Reporting System version 2 (PI-RADSv2) to determine a need for biopsy in detecting prostate cancer (PCa). We report the use of PIRADSv2 to assess for PCa in a cohort of British men undergoing cognitive-targeted versus fusion-guided and template-guided prostate biopsies.
Materials and Methods
MRI PI-RADSv2 scores (≥3 considered as positively predictive) and biopsy data was collected from 2017-2019 via electronic records across three major urological centres, with each offering a different modality of prostate biopsy. The primary outcome was diagnosis of clinically significant (Gleason score ≥3+4=7) PCa.
Results
In total, 663 men met the inclusion criteria. 162 men had cognitive-targeted prostate biopsies: PI-RADSv2 ≥3 correlated to a sensitivity of 0.985 and specificity of 0.391, with 80.2% of men having clinically significant PCa. 310 men had fusion-guided prostate biopsies: PI-RADSv2 ≥3 correlated to a sensitivity of 0.994 and specificity of 0.474, with 92.9% having clinically significant PCa. 191 men had template-guided prostate biopsies: PI-RADSv2 ≥3 correlated to a sensitivity of 0.980 and specificity of 0.439, with 76.4% of men having clinically significant PCa.
Conclusions
Cognitive-targeted biopsy yielded lower rates of clinically significant PCa in PI-RADSv2 score 4 and 5 lesions, compared to using fusion-guided biopsy. Our data shows PI-RADSv2 does not have adequate specificity rates to be used as a sole screening tool. The detection rate for clinically significant PCa was highest in the fusion-guided biopsy cohort.
European Association of Urology recommends multiparametric magnetic resonance imaging (mpMRI) of the prostate, combined with standardised reporting using the Prostate Imaging and Data Reporting System version 2 (PI-RADSv2) to determine a need for biopsy in detecting prostate cancer (PCa). We report the use of PIRADSv2 to assess for PCa in a cohort of British men undergoing cognitive-targeted versus fusion-guided and template-guided prostate biopsies.
Materials and Methods
MRI PI-RADSv2 scores (≥3 considered as positively predictive) and biopsy data was collected from 2017-2019 via electronic records across three major urological centres, with each offering a different modality of prostate biopsy. The primary outcome was diagnosis of clinically significant (Gleason score ≥3+4=7) PCa.
Results
In total, 663 men met the inclusion criteria. 162 men had cognitive-targeted prostate biopsies: PI-RADSv2 ≥3 correlated to a sensitivity of 0.985 and specificity of 0.391, with 80.2% of men having clinically significant PCa. 310 men had fusion-guided prostate biopsies: PI-RADSv2 ≥3 correlated to a sensitivity of 0.994 and specificity of 0.474, with 92.9% having clinically significant PCa. 191 men had template-guided prostate biopsies: PI-RADSv2 ≥3 correlated to a sensitivity of 0.980 and specificity of 0.439, with 76.4% of men having clinically significant PCa.
Conclusions
Cognitive-targeted biopsy yielded lower rates of clinically significant PCa in PI-RADSv2 score 4 and 5 lesions, compared to using fusion-guided biopsy. Our data shows PI-RADSv2 does not have adequate specificity rates to be used as a sole screening tool. The detection rate for clinically significant PCa was highest in the fusion-guided biopsy cohort.
Introduction
European Association of Urology recommends multiparametric magnetic resonance imaging (mpMRI) of the prostate, combined with standardised reporting using the Prostate Imaging and Data Reporting System version 2 (PI-RADSv2) to determine a need for biopsy in detecting prostate cancer (PCa). We report the use of PIRADSv2 to assess for PCa in a cohort of British men undergoing cognitive-targeted versus fusion-guided and template-guided prostate biopsies.
Materials and Methods
MRI PI-RADSv2 scores (≥3 considered as positively predictive) and biopsy data was collected from 2017-2019 via electronic records across three major urological centres, with each offering a different modality of prostate biopsy. The primary outcome was diagnosis of clinically significant (Gleason score ≥3+4=7) PCa.
Results
In total, 663 men met the inclusion criteria. 162 men had cognitive-targeted prostate biopsies: PI-RADSv2 ≥3 correlated to a sensitivity of 0.985 and specificity of 0.391, with 80.2% of men having clinically significant PCa. 310 men had fusion-guided prostate biopsies: PI-RADSv2 ≥3 correlated to a sensitivity of 0.994 and specificity of 0.474, with 92.9% having clinically significant PCa. 191 men had template-guided prostate biopsies: PI-RADSv2 ≥3 correlated to a sensitivity of 0.980 and specificity of 0.439, with 76.4% of men having clinically significant PCa.
Conclusions
Cognitive-targeted biopsy yielded lower rates of clinically significant PCa in PI-RADSv2 score 4 and 5 lesions, compared to using fusion-guided biopsy. Our data shows PI-RADSv2 does not have adequate specificity rates to be used as a sole screening tool. The detection rate for clinically significant PCa was highest in the fusion-guided biopsy cohort.
European Association of Urology recommends multiparametric magnetic resonance imaging (mpMRI) of the prostate, combined with standardised reporting using the Prostate Imaging and Data Reporting System version 2 (PI-RADSv2) to determine a need for biopsy in detecting prostate cancer (PCa). We report the use of PIRADSv2 to assess for PCa in a cohort of British men undergoing cognitive-targeted versus fusion-guided and template-guided prostate biopsies.
Materials and Methods
MRI PI-RADSv2 scores (≥3 considered as positively predictive) and biopsy data was collected from 2017-2019 via electronic records across three major urological centres, with each offering a different modality of prostate biopsy. The primary outcome was diagnosis of clinically significant (Gleason score ≥3+4=7) PCa.
Results
In total, 663 men met the inclusion criteria. 162 men had cognitive-targeted prostate biopsies: PI-RADSv2 ≥3 correlated to a sensitivity of 0.985 and specificity of 0.391, with 80.2% of men having clinically significant PCa. 310 men had fusion-guided prostate biopsies: PI-RADSv2 ≥3 correlated to a sensitivity of 0.994 and specificity of 0.474, with 92.9% having clinically significant PCa. 191 men had template-guided prostate biopsies: PI-RADSv2 ≥3 correlated to a sensitivity of 0.980 and specificity of 0.439, with 76.4% of men having clinically significant PCa.
Conclusions
Cognitive-targeted biopsy yielded lower rates of clinically significant PCa in PI-RADSv2 score 4 and 5 lesions, compared to using fusion-guided biopsy. Our data shows PI-RADSv2 does not have adequate specificity rates to be used as a sole screening tool. The detection rate for clinically significant PCa was highest in the fusion-guided biopsy cohort.
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