Concordance of MRI-Guided Fusion and Systematic 12-Core Prostate Biopsy for the Detection of Prostate Cancer

BackgroundMRI-guided fusion biopsy is increasingly utilized over systematic 12-core biopsy for men with MRI-visible prostate lesions.Patients and MethodsPatients with MRI visible lesions who underwent MRI-guided fusion and systematic 12-core biopsy from 2016-2020 in the Intermountain Healthcare (IHC...

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Main Authors: Matthew Parsons, Zoya Sandhu, Bridget Foy, Ernest Chan, Bryan Crawford, Libby Petersen, Benjamin Romney, Daniel Sommers, Jay Bishoff, Steven Lynch, Logan Mclean, David Gill
Format: Article
Language:English
Published: Frontiers Media S.A. 2022-05-01
Series:Frontiers in Oncology
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2022.899567/full
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author Matthew Parsons
Zoya Sandhu
Bridget Foy
Ernest Chan
Bryan Crawford
Libby Petersen
Benjamin Romney
Daniel Sommers
Jay Bishoff
Steven Lynch
Logan Mclean
David Gill
author_facet Matthew Parsons
Zoya Sandhu
Bridget Foy
Ernest Chan
Bryan Crawford
Libby Petersen
Benjamin Romney
Daniel Sommers
Jay Bishoff
Steven Lynch
Logan Mclean
David Gill
author_sort Matthew Parsons
collection DOAJ
description BackgroundMRI-guided fusion biopsy is increasingly utilized over systematic 12-core biopsy for men with MRI-visible prostate lesions.Patients and MethodsPatients with MRI visible lesions who underwent MRI-guided fusion and systematic 12-core biopsy from 2016-2020 in the Intermountain Healthcare (IHC) system were consecutively analyzed. This was in the setting of a continuous quality assurance initiative among the reading radiologists. Primary outcome was prostate cancer (PCa) detection defined by Gleason grade group (GGG) 1 or higher. Clinically significant cancer (CSC) was defined as GGG 2 or higher. Patients were stratified by biopsy date, 2016-2017 and 2018-2021, and lesions were stratified by PI-RADS v2 category.ResultsA total of 184 patients with 324 MRI-detectable lesions underwent both biopsy modalities in the IHC system from 2016 to 2021. CSC was detected in 23.5% of MRI-guided fusion biopsies. Comparing PI-RAD v2 categories 1-3 to categories 4-5, rate of CSC was 10% and 42% respectively. MRI-guided fusion and systematic 12-core biopsies were concordant for PCa in 77% of men and CSC in 83%. MRI-guided fusion biopsy detected PCa in 26/103 and CSC in 20/131 men in whom systematic 12-core biopsy was negative. Systematic 12-core biopsy detected PCa in 17/94 and CSC in 11/122 men in whom MRI-guided fusion was negative.ConclusionsOmitting MRI-guided fusion or systematic 12-core biopsy would have resulted in underdiagnosis of CSC in 11% or 6% of patients respectively. Combining biopsies increased detection rate of CSC. This was in the setting of a continuous quality assurance program at a large community-based hospital.
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spelling doaj.art-7d0531fe8ab343c4b9be10202651ce662022-12-22T00:35:04ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2022-05-011210.3389/fonc.2022.899567899567Concordance of MRI-Guided Fusion and Systematic 12-Core Prostate Biopsy for the Detection of Prostate CancerMatthew Parsons0Zoya Sandhu1Bridget Foy2Ernest Chan3Bryan Crawford4Libby Petersen5Benjamin Romney6Daniel Sommers7Jay Bishoff8Steven Lynch9Logan Mclean10David Gill11Department of Radiation Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, United StatesCollege of Osteopathic Medicine, Rocky Vista University, Ivins, UT, United StatesIntermountain Medical Center, Murray, UT, United StatesIntermountain Medical Center, Murray, UT, United StatesIntermountain Medical Center, Murray, UT, United StatesIntermountain Medical Center, Murray, UT, United StatesIntermountain Medical Center, Murray, UT, United StatesIntermountain Medical Center, Murray, UT, United StatesIntermountain Medical Center, Murray, UT, United StatesIntermountain Medical Center, Murray, UT, United StatesIntermountain Medical Center, Murray, UT, United StatesIntermountain Medical Center, Murray, UT, United StatesBackgroundMRI-guided fusion biopsy is increasingly utilized over systematic 12-core biopsy for men with MRI-visible prostate lesions.Patients and MethodsPatients with MRI visible lesions who underwent MRI-guided fusion and systematic 12-core biopsy from 2016-2020 in the Intermountain Healthcare (IHC) system were consecutively analyzed. This was in the setting of a continuous quality assurance initiative among the reading radiologists. Primary outcome was prostate cancer (PCa) detection defined by Gleason grade group (GGG) 1 or higher. Clinically significant cancer (CSC) was defined as GGG 2 or higher. Patients were stratified by biopsy date, 2016-2017 and 2018-2021, and lesions were stratified by PI-RADS v2 category.ResultsA total of 184 patients with 324 MRI-detectable lesions underwent both biopsy modalities in the IHC system from 2016 to 2021. CSC was detected in 23.5% of MRI-guided fusion biopsies. Comparing PI-RAD v2 categories 1-3 to categories 4-5, rate of CSC was 10% and 42% respectively. MRI-guided fusion and systematic 12-core biopsies were concordant for PCa in 77% of men and CSC in 83%. MRI-guided fusion biopsy detected PCa in 26/103 and CSC in 20/131 men in whom systematic 12-core biopsy was negative. Systematic 12-core biopsy detected PCa in 17/94 and CSC in 11/122 men in whom MRI-guided fusion was negative.ConclusionsOmitting MRI-guided fusion or systematic 12-core biopsy would have resulted in underdiagnosis of CSC in 11% or 6% of patients respectively. Combining biopsies increased detection rate of CSC. This was in the setting of a continuous quality assurance program at a large community-based hospital.https://www.frontiersin.org/articles/10.3389/fonc.2022.899567/fullprostate cancerbiopsy - methodsMRI guidancequality improvement12 core biopsy
spellingShingle Matthew Parsons
Zoya Sandhu
Bridget Foy
Ernest Chan
Bryan Crawford
Libby Petersen
Benjamin Romney
Daniel Sommers
Jay Bishoff
Steven Lynch
Logan Mclean
David Gill
Concordance of MRI-Guided Fusion and Systematic 12-Core Prostate Biopsy for the Detection of Prostate Cancer
Frontiers in Oncology
prostate cancer
biopsy - methods
MRI guidance
quality improvement
12 core biopsy
title Concordance of MRI-Guided Fusion and Systematic 12-Core Prostate Biopsy for the Detection of Prostate Cancer
title_full Concordance of MRI-Guided Fusion and Systematic 12-Core Prostate Biopsy for the Detection of Prostate Cancer
title_fullStr Concordance of MRI-Guided Fusion and Systematic 12-Core Prostate Biopsy for the Detection of Prostate Cancer
title_full_unstemmed Concordance of MRI-Guided Fusion and Systematic 12-Core Prostate Biopsy for the Detection of Prostate Cancer
title_short Concordance of MRI-Guided Fusion and Systematic 12-Core Prostate Biopsy for the Detection of Prostate Cancer
title_sort concordance of mri guided fusion and systematic 12 core prostate biopsy for the detection of prostate cancer
topic prostate cancer
biopsy - methods
MRI guidance
quality improvement
12 core biopsy
url https://www.frontiersin.org/articles/10.3389/fonc.2022.899567/full
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