What is the ideal number of biopsy cores per lesion in targeted prostate biopsy?

Background: The number of cores to be obtained in targeted biopsy (TB) is important. This study aimed to evaluate the TB outcomes in suspicious prostate lesions classified according to the Prostate Imaging Reporting and Data System (PI-RADS) and to determine the ideal number of biopsy cores per lesi...

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Main Authors: Gokhan Sonmez, Turev Demirtas, Sevket T. Tombul, Figen Ozturk, Abdullah Demirtas
Format: Article
Language:English
Published: Elsevier 2020-09-01
Series:Prostate International
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2287888220300271
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author Gokhan Sonmez
Turev Demirtas
Sevket T. Tombul
Figen Ozturk
Abdullah Demirtas
author_facet Gokhan Sonmez
Turev Demirtas
Sevket T. Tombul
Figen Ozturk
Abdullah Demirtas
author_sort Gokhan Sonmez
collection DOAJ
description Background: The number of cores to be obtained in targeted biopsy (TB) is important. This study aimed to evaluate the TB outcomes in suspicious prostate lesions classified according to the Prostate Imaging Reporting and Data System (PI-RADS) and to determine the ideal number of biopsy cores per lesion. Methods: This retrospective study included patients who underwent multiparametric magnetic resonance imaging–guided fusion prostate biopsy owing to increased serum prostate-specific antigen (PSA) levels and suspicious digital rectal examination outcomes in our institute. Patients with PI-RADS <3 lesions, PSA levels >10 ng/ml, and a prior diagnosis of prostate cancer (PCa) (active surveillance) were excluded from the study. The number of biopsy cores to be obtained from each lesion was determined by the clinician. Results: The study included a total of 418 patients and 684 lesions. Among PI-RADS 3 lesions, clinically significant PCa (sPCa) detection rate was similar in the lesions from which 2 and 3 cores were obtained (9.1% and 10.0%, respectively), whereas it was relatively higher in the lesions from which 4 biopsy cores were obtained (18.5%). Among PI-RADS 4 lesions, sPCa detection rate was similar in the lesions from which 3 and 4 cores were obtained (35.6% and 32.3%, respectively), whereas it was relatively lower in the lesions from which 2 biopsy cores were obtained (17.9%). Among PI-RADS 5 lesions, however, sPCa detection rate was similar in the lesions from which 2, 3, or 4 cores were obtained (47.6%, 46.0%, 48.9%, respectively). Conclusion: The results indicated that the ideal number of cores to be obtained from each suspicious lesion in TB depends on the characteristics of the lesions. Accordingly, while obtaining 2–3 biopsy cores could be adequate in PI-RADS 4 and 5 lesions, which have a serious risk of cancer, a minimum of 4 biopsy cores should be obtained from PI-RADS 3 lesions to ensure accurate histopathological results.Clinical trial number (ClinicalTrials.gov)NCT03936296.
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spelling doaj.art-692873a09a224ef5ba7781c7114b6f6d2023-08-02T02:38:49ZengElsevierProstate International2287-88822020-09-0183112115What is the ideal number of biopsy cores per lesion in targeted prostate biopsy?Gokhan Sonmez0Turev Demirtas1Sevket T. Tombul2Figen Ozturk3Abdullah Demirtas4Erciyes University, Department of Urology, Kayseri, TurkeyErciyes University, Department of Medical History and Ethics, Kayseri, TurkeyErciyes University, Department of Urology, Kayseri, TurkeyErciyes University, Department of Pathology, Kayseri, TurkeyErciyes University, Department of Urology, Kayseri, Turkey; Corresponding author. Erciyes Üniversitesi, Gevher Nesibe Hastanesi, 1. Kat Üroloji Kliniği, Melikgazi, Kayseri, Türkiye.Background: The number of cores to be obtained in targeted biopsy (TB) is important. This study aimed to evaluate the TB outcomes in suspicious prostate lesions classified according to the Prostate Imaging Reporting and Data System (PI-RADS) and to determine the ideal number of biopsy cores per lesion. Methods: This retrospective study included patients who underwent multiparametric magnetic resonance imaging–guided fusion prostate biopsy owing to increased serum prostate-specific antigen (PSA) levels and suspicious digital rectal examination outcomes in our institute. Patients with PI-RADS <3 lesions, PSA levels >10 ng/ml, and a prior diagnosis of prostate cancer (PCa) (active surveillance) were excluded from the study. The number of biopsy cores to be obtained from each lesion was determined by the clinician. Results: The study included a total of 418 patients and 684 lesions. Among PI-RADS 3 lesions, clinically significant PCa (sPCa) detection rate was similar in the lesions from which 2 and 3 cores were obtained (9.1% and 10.0%, respectively), whereas it was relatively higher in the lesions from which 4 biopsy cores were obtained (18.5%). Among PI-RADS 4 lesions, sPCa detection rate was similar in the lesions from which 3 and 4 cores were obtained (35.6% and 32.3%, respectively), whereas it was relatively lower in the lesions from which 2 biopsy cores were obtained (17.9%). Among PI-RADS 5 lesions, however, sPCa detection rate was similar in the lesions from which 2, 3, or 4 cores were obtained (47.6%, 46.0%, 48.9%, respectively). Conclusion: The results indicated that the ideal number of cores to be obtained from each suspicious lesion in TB depends on the characteristics of the lesions. Accordingly, while obtaining 2–3 biopsy cores could be adequate in PI-RADS 4 and 5 lesions, which have a serious risk of cancer, a minimum of 4 biopsy cores should be obtained from PI-RADS 3 lesions to ensure accurate histopathological results.Clinical trial number (ClinicalTrials.gov)NCT03936296.http://www.sciencedirect.com/science/article/pii/S2287888220300271corenumberprostatetargetbiopsy
spellingShingle Gokhan Sonmez
Turev Demirtas
Sevket T. Tombul
Figen Ozturk
Abdullah Demirtas
What is the ideal number of biopsy cores per lesion in targeted prostate biopsy?
Prostate International
core
number
prostate
target
biopsy
title What is the ideal number of biopsy cores per lesion in targeted prostate biopsy?
title_full What is the ideal number of biopsy cores per lesion in targeted prostate biopsy?
title_fullStr What is the ideal number of biopsy cores per lesion in targeted prostate biopsy?
title_full_unstemmed What is the ideal number of biopsy cores per lesion in targeted prostate biopsy?
title_short What is the ideal number of biopsy cores per lesion in targeted prostate biopsy?
title_sort what is the ideal number of biopsy cores per lesion in targeted prostate biopsy
topic core
number
prostate
target
biopsy
url http://www.sciencedirect.com/science/article/pii/S2287888220300271
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