The Detection of Prostate Cancer with Magnetic Resonance Imaging-Targeted Prostate Biopsies is Superior with the Transperineal vs the Transrectal Approach. A European Association of Urology-Young Academic Urologists Prostate Cancer Working Group Multi-Institutional Study

Zattoni, F; Marra, G; Kasivisvanathan, V; Grummet, J; Nandurkar, R; Ploussard, G; Olivier, J; Chiu, PK; Valerio, M; Gontero, P; Guo, H; Zhuang, J; Barletta, F; Leni, R; Frydenberg, M; Moon, D; Hanegbi, U; Landaumailto, A; Snow, R; Apfelbeck, M; Kretschmer, A; van den Bergh, R; Novara, G; Briganti, A; Dal Moro, F; Gandaglia, G; EAU-YAU Prostate Cancer Working Party and Collaborators

Author(s): Zattoni, F; Marra, G; Kasivisvanathan, V; Grummet, J; Nandurkar, R; Ploussard, G; Olivier, J; Chiu, PK; Valerio, M; Gontero, P; Guo, H; Zhuang, J; Barletta, F; Leni, R; Frydenberg, M; Moon, D; Hanegbi, U; Landaumailto, A; Snow, R; Apfelbeck, M; Kretschmer, A; van den Bergh, R; Novara, G; Briganti, A; Dal Moro, F; Gandaglia, G; EAU-YAU Prostate Cancer Working Party and Collaborators;
Details: Publication Year 2022-10,Volume 208,Issue #4,Page 830-837
Journal Title: Journal of Urology
Publication Type: Research article
Abstract: PURPOSE: Our aim was to evaluate whether transperineal (TP) MRI-targeted prostate biopsy (TBx) may improve the detection of clinically significant prostate cancer (csPCa), defined as International Society of Urological Pathology >/=2, in comparison to transrectal (TR) TBx. MATERIALS AND METHODS: A multicenter retrospective cohort study comprising patients who underwent MRI-guided prostate biopsy was conducted. To address possible benefits of TP-TBx in the detection of prostate cancer (PCa) and csPCa, a cohort of patients undergoing TP-TBx were compared to patients undergoing TR-TBx. Multivariable logistic regression analyses were performed to assess predictors of PCa and csPCa detection. RESULTS: Overall, 1,936 and 3,305 patients who underwent TR-TBx vs TP-TBx at 10 referral centers were enrolled. The rate of PCa and csPCa diagnosed was higher for TP-TBx vs TR-TBx (64.0% vs 50%, p <0.01 and 49% vs 35%, p <0.01). At multivariable analysis adjusted for age, biopsy naive/repeated biopsy, cT stage, Prostate Imaging-Reporting and Data System(R), prostate volume, PSA, and number of biopsy cores targeted, TP-TBx was an independent predictor of PCa (odds ratio [OR] 1.37, 95% CI 1.08-1.72) and csPCa (1.19, 95% CI 1.12-1.50). When considering the approach according to the site of the index lesion, TP-TBx had a significantly higher likelihood than TR-TBx to detect csPCa in the apex (OR 4.81, 95% CI 1.03-6.27), transition/central zone (OR 2.67, 95% CI 1.42-5.00), and anterior zone (OR 5.62, 95% CI 1.74-8.13). CONCLUSIONS: The use of TP-TBx allows a better cancer grade definition and PCa risk assessment. This has important implication in the decision-making process and in patient counseling for further therapies.
Keywords: Humans; Image-Guided Biopsy; Magnetic Resonance Imaging; Male; Prostate/diagnostic imaging/pathology; *Prostatic Neoplasms/diagnostic imaging/pathology; Retrospective Studies; Urologists; *Urology; biopsy, needle; diagnosis; multiparametric magnetic resonance imaging; prostatic neoplasms
Department(s): Surgical Oncology
PubMed ID: 36082555
Publisher's Version: https://doi.org/10.1097/JU.0000000000002802
Terms of Use/Rights Notice: Refer to copyright notice on published article.

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