A Diagnostic Accuracy Study of Targeted and Systematic Biopsies to Detect Clinically Significant Prostate Cancer, including a Model for the Partial Omission of Systematic Biopsies
The primary objective of this study was to analyse the current accuracy of targeted and systematic prostate biopsies in detecting csPCa. A secondary objective was to determine whether there are factors predicting the finding of csPCa in targeted biopsies and, if so, to explore the utility of a predi...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-09-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/15/18/4543 |
| _version_ | 1797580860528001024 |
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| author | Juan Morote Natàlia Picola Jesús Muñoz-Rodriguez Nahuel Paesano Xavier Ruiz-Plazas Marta V. Muñoz-Rivero Anna Celma Gemma García-de Manuel Ignacio Aisian Pol Servian José M. Abascal |
| author_facet | Juan Morote Natàlia Picola Jesús Muñoz-Rodriguez Nahuel Paesano Xavier Ruiz-Plazas Marta V. Muñoz-Rivero Anna Celma Gemma García-de Manuel Ignacio Aisian Pol Servian José M. Abascal |
| author_sort | Juan Morote |
| collection | DOAJ |
| description | The primary objective of this study was to analyse the current accuracy of targeted and systematic prostate biopsies in detecting csPCa. A secondary objective was to determine whether there are factors predicting the finding of csPCa in targeted biopsies and, if so, to explore the utility of a predictive model for csPCa detection only in targeted biopsies. We analysed 2122 men with suspected PCa, serum PSA > 3 ng/mL, and/or a suspicious digital rectal examination (DRE), who underwent targeted and systematic biopsies between 2021 and 2022. CsPCa (grade group 2 or higher) was detected in 1026 men (48.4%). Discrepancies in csPCa detection in targeted and systematic biopsies were observed in 49.6%, with 13.9% of csPCa cases being detected only in systematic biopsies and 35.7% only in targeted biopsies. A predictive model for csPCa detection only in targeted biopsies was developed from the independent predictors age (years), prostate volume (mL), PI-RADS score (3 to 5), mpMRI Tesla (1.5 vs. 3.0), TRUS-MRI fusion image technique (cognitive vs. software), and prostate biopsy route (transrectal vs. transperineal). The csPCa discrimination ability of targeted biopsies showed an AUC of 0.741 (95% CI 0.721–0.762). The avoidance rate of systematic prostate biopsies went from 0.5% without missing csPCa to 18.3% missing 4.6% of csPCa cases. We conclude that the csPCa diagnostic accuracy of targeted biopsies is higher than that of systematic biopsies. However, a significant rate of csPCa remains detected only in systematic biopsies. A predictive model for the partial omission of systematic biopsies was developed. |
| first_indexed | 2024-03-10T22:56:58Z |
| format | Article |
| id | doaj.art-23ae774399974a43a5e369fe2eadaa2b |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T22:56:58Z |
| publishDate | 2023-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-23ae774399974a43a5e369fe2eadaa2b2023-11-19T09:55:16ZengMDPI AGCancers2072-66942023-09-011518454310.3390/cancers15184543A Diagnostic Accuracy Study of Targeted and Systematic Biopsies to Detect Clinically Significant Prostate Cancer, including a Model for the Partial Omission of Systematic BiopsiesJuan Morote0Natàlia Picola1Jesús Muñoz-Rodriguez2Nahuel Paesano3Xavier Ruiz-Plazas4Marta V. Muñoz-Rivero5Anna Celma6Gemma García-de Manuel7Ignacio Aisian8Pol Servian9José M. Abascal10Department of Urology, Vall d’Hebron Hospital, 08035 Barcelona, SpainDepartment of Urology, Hospital Universitari de Bellvitge, 08907 Hospitalet de Llobregat, SpainDepartment of Urology, Hospital Universitari Parc Taulí, 08208 Sabadell, SpainClínica Creu Blanca, 08034 Barcelona, SpainDepartment of Urology, Hospital Universitari Joan XXIII, 43005 Tarragona, SpainDepartment of Urology, Hospital Arnau de Vilanova, 25198 Lleida, SpainDepartment of Urology, Vall d’Hebron Hospital, 08035 Barcelona, SpainDepartment of Urology, Hospital Universitari Josep Trueta, 17007 Girona, SpainDepartment of Urology, Hospital Clinic, 08036 Barcelona, SpainDepartment of Urology, Hospital Germans Trias i Pujol, 08916 Badalona, SpainDepartment of Urology, Parc de Salut Mar, 08003 Barcelona, SpainThe primary objective of this study was to analyse the current accuracy of targeted and systematic prostate biopsies in detecting csPCa. A secondary objective was to determine whether there are factors predicting the finding of csPCa in targeted biopsies and, if so, to explore the utility of a predictive model for csPCa detection only in targeted biopsies. We analysed 2122 men with suspected PCa, serum PSA > 3 ng/mL, and/or a suspicious digital rectal examination (DRE), who underwent targeted and systematic biopsies between 2021 and 2022. CsPCa (grade group 2 or higher) was detected in 1026 men (48.4%). Discrepancies in csPCa detection in targeted and systematic biopsies were observed in 49.6%, with 13.9% of csPCa cases being detected only in systematic biopsies and 35.7% only in targeted biopsies. A predictive model for csPCa detection only in targeted biopsies was developed from the independent predictors age (years), prostate volume (mL), PI-RADS score (3 to 5), mpMRI Tesla (1.5 vs. 3.0), TRUS-MRI fusion image technique (cognitive vs. software), and prostate biopsy route (transrectal vs. transperineal). The csPCa discrimination ability of targeted biopsies showed an AUC of 0.741 (95% CI 0.721–0.762). The avoidance rate of systematic prostate biopsies went from 0.5% without missing csPCa to 18.3% missing 4.6% of csPCa cases. We conclude that the csPCa diagnostic accuracy of targeted biopsies is higher than that of systematic biopsies. However, a significant rate of csPCa remains detected only in systematic biopsies. A predictive model for the partial omission of systematic biopsies was developed.https://www.mdpi.com/2072-6694/15/18/4543clinically significant prostate cancer detectionsystematic biopsytargeted biopsyprostate biopsy concordance |
| spellingShingle | Juan Morote Natàlia Picola Jesús Muñoz-Rodriguez Nahuel Paesano Xavier Ruiz-Plazas Marta V. Muñoz-Rivero Anna Celma Gemma García-de Manuel Ignacio Aisian Pol Servian José M. Abascal A Diagnostic Accuracy Study of Targeted and Systematic Biopsies to Detect Clinically Significant Prostate Cancer, including a Model for the Partial Omission of Systematic Biopsies Cancers clinically significant prostate cancer detection systematic biopsy targeted biopsy prostate biopsy concordance |
| title | A Diagnostic Accuracy Study of Targeted and Systematic Biopsies to Detect Clinically Significant Prostate Cancer, including a Model for the Partial Omission of Systematic Biopsies |
| title_full | A Diagnostic Accuracy Study of Targeted and Systematic Biopsies to Detect Clinically Significant Prostate Cancer, including a Model for the Partial Omission of Systematic Biopsies |
| title_fullStr | A Diagnostic Accuracy Study of Targeted and Systematic Biopsies to Detect Clinically Significant Prostate Cancer, including a Model for the Partial Omission of Systematic Biopsies |
| title_full_unstemmed | A Diagnostic Accuracy Study of Targeted and Systematic Biopsies to Detect Clinically Significant Prostate Cancer, including a Model for the Partial Omission of Systematic Biopsies |
| title_short | A Diagnostic Accuracy Study of Targeted and Systematic Biopsies to Detect Clinically Significant Prostate Cancer, including a Model for the Partial Omission of Systematic Biopsies |
| title_sort | diagnostic accuracy study of targeted and systematic biopsies to detect clinically significant prostate cancer including a model for the partial omission of systematic biopsies |
| topic | clinically significant prostate cancer detection systematic biopsy targeted biopsy prostate biopsy concordance |
| url | https://www.mdpi.com/2072-6694/15/18/4543 |
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