[Prospective comparison of cognitive and mpMR/US fusion biopsy for prostate cancer detection]

V S Petov; A K Bazarkin; A O Morozov; M S Taratkin; T M Ganzha; S P Danilov; Y N Chernov; D V Chinenov; A V Amosov; D V Enikeev; G E Krupinov

[Prospective comparison of cognitive and mpMR/US fusion biopsy for prostate cancer detection]

Urologiia. 2022 Sep:(4):38-43.

[Article in Russian]

Authors

V S Petov^{1

2}, A K Bazarkin^{1

2}, A O Morozov^{1

2}, M S Taratkin^{1

2}, T M Ganzha^{1

2}, S P Danilov^{1

2}, Y N Chernov^{1

2}, D V Chinenov^{1

2}, A V Amosov^{1

2}, D V Enikeev^{1

2}, G E Krupinov^{1

2}

Affiliations

¹ Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia.
² Institute for clinical medicine named after N.V. Sklifosovsky, Sechenov University, Moscow, Russia.

PMID: 36098588

Abstract

Introduction: According to the recommendations of the European Association of Urology the presence of a suspicious lesion on MRI is an indication for both primary and secondary MR-targeted biopsies. At the same time, the Russian Society of Urologists recommends to perform mpMR/US fusion biopsy only in patients with a prior negative biopsy. In clinical practice, mpMR/US fusion and cognitive biopsies are the most frequently performed. However, when comparing them, contradictory data on detection of clinically significant prostate cancer is obtained.

Objective: to compare the detection rate of clinically significant prostate cancer performing cognitive and mpMR/US fusion biopsies.

Materials and methods: Inclusion criteria: PSA >2 ng/mL and/or a positive DRE, and/or a suspicious lesion on TRUS, and PI-RADSv2.1 lesion more or equal 3. At first, "unblinded" urologist performed a transperineal mpMR/ultrasound fusion and saturation biopsy. Then "blinded" urologist obtained transrectal cognitive biopsy Clinically significant cancer was defined as ISUP more or equal 2.

Results: We enrolled 96 patients. Median age was 63 years, prostate volume - 47 cm3 and PSA - 6.82 ng/mL. MpMR/US fusion and cognitive biopsies were comparable in regard to the detection rate of clinically significant (32.3% vs 25.0%; p=0.264), clinically insignificant cancer (25.0% and 26.0%; p=0.869) and overall detection rate (57.3% and 51%;p=0.385). Both biopsies missed clinically significant cancer with equal frequency (5.2%; p=0.839). Histological efficacy also was comparable. The number of positive cores between mpMR/US fusion and cognitive biopsy was equal (34.1% and 31.1% respectively; p= 0.415). At the same time, no statistically significant difference was found with respect to maximum cancer core length (53.1% vs 47.7%, respectively; p=0.293).

Conclusion: The results suggest that both cognitive and mpMR/US fusion biopsies are equally accurate diagnostic methods for clinically significant prostate cancer detection, thus their wider introduction into clinical practice is necessary.

Keywords: clinically significant prostate cancer; cognitive biopsy; mpMR/US fusion biopsy.

MeSH terms

Cognition
Humans
Image-Guided Biopsy / methods
Male
Middle Aged
Prostate* / diagnostic imaging
Prostate* / pathology
Prostate-Specific Antigen
Prostatic Neoplasms* / diagnostic imaging
Prostatic Neoplasms* / pathology

Substances

Prostate-Specific Antigen