Comparison of prostate biopsy with or without pre-biopsy multi-parametric MRI in prostate cancer detection: an observational cohort study
<h4>Purpose</h4> <p>We hypothesized that 1) introducing pre-biopsy multiparametric magnetic resonance imaging (PB-mpMRI) increases the diagnostic yield of transrectal prostate biopsy (TRPB), and 2) this would inform recommendations regarding systematic TRPB in the “negative” PB-mp...
| প্রধান লেখক: | , , , , , , , , , , , |
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| বিন্যাস: | Journal article |
| ভাষা: | English |
| প্রকাশিত: |
Elsevier
2018
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| _version_ | 1826273533061234688 |
|---|---|
| author | Bryant, R Hobbs, C Eyre, K Davies, L Sullivan, M Shields, W Sooriakumaran, P Verrill, C Gleeson, F Macpherson, R Hamdy, F Brewster, S |
| author_facet | Bryant, R Hobbs, C Eyre, K Davies, L Sullivan, M Shields, W Sooriakumaran, P Verrill, C Gleeson, F Macpherson, R Hamdy, F Brewster, S |
| author_sort | Bryant, R |
| collection | OXFORD |
| description | <h4>Purpose</h4> <p>We hypothesized that 1) introducing pre-biopsy multiparametric magnetic resonance imaging (PB-mpMRI) increases the diagnostic yield of transrectal prostate biopsy (TRPB), and 2) this would inform recommendations regarding systematic TRPB in the “negative” PB-mpMRI setting.</p> <h4>Materials and methods</h4> <p>Nine hundred and ninety-seven biopsy-naïve patients underwent TRPB alone to June 2016 (cohort A), and seven hundred and ninety-two underwent TRPB following PB-mpMRI thereafter (cohort B). Patients with PB-mpMRI lesions underwent “cognitive-targeted” plus systematic TRPB. Patients without lesions underwent systematic TRPB.</p> <h4>Results</h4> <p>Cohort B comprised younger (68 v 69 years, p=0.01) men with lower PSA (7.6 v 7.9 ng/mL, p=0.024) and prostate volume (56.1 v 62cc, p=0.006). There was no increase in overall PCa detection (57.6 v 56.7%, p=0.701), Gleason grade group (GGG), or number of positive cores (p>0.05 for each) in Cohort B versus Cohort A. Increased multi-focal prostatic intraepithelial neoplasia, maximum PCa core length (≥5mm versus <5mm), and radical surgery/HIFU (p<0.05 for each) was observed in Cohort B. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of a “negative” PB-mpMRI for GGG 2-5 PCa were 88.1%, 59.8%, 67.8% and 84% respectively. For “negative” PB-mpMRIs, a PSAd≥0.15 cut-point only increased “clinically significant” PCa detection if the latter was defined as GGG 3-5 disease and/or tumor length ≥6mm.</p> <h4>Conclusions</h4> <p>Introducing PB-mpMRI in our clinical setting increased the diagnostic yield of PCa per biopsy core. Not performing a systematic TRPB when the PB-mpMRI was "negative" would have led to under-detection of 15.1% (approximately 1 in 6) of GGG≥2 PCa cases.</p> |
| first_indexed | 2024-03-06T22:29:38Z |
| format | Journal article |
| id | oxford-uuid:57dc8df3-6164-402b-bf0e-57f283cde4fc |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T22:29:38Z |
| publishDate | 2018 |
| publisher | Elsevier |
| record_format | dspace |
| spelling | oxford-uuid:57dc8df3-6164-402b-bf0e-57f283cde4fc2022-03-26T16:59:18ZComparison of prostate biopsy with or without pre-biopsy multi-parametric MRI in prostate cancer detection: an observational cohort studyJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:57dc8df3-6164-402b-bf0e-57f283cde4fcEnglishSymplectic Elements at OxfordElsevier2018Bryant, RHobbs, CEyre, KDavies, LSullivan, MShields, WSooriakumaran, PVerrill, CGleeson, FMacpherson, RHamdy, FBrewster, S <h4>Purpose</h4> <p>We hypothesized that 1) introducing pre-biopsy multiparametric magnetic resonance imaging (PB-mpMRI) increases the diagnostic yield of transrectal prostate biopsy (TRPB), and 2) this would inform recommendations regarding systematic TRPB in the “negative” PB-mpMRI setting.</p> <h4>Materials and methods</h4> <p>Nine hundred and ninety-seven biopsy-naïve patients underwent TRPB alone to June 2016 (cohort A), and seven hundred and ninety-two underwent TRPB following PB-mpMRI thereafter (cohort B). Patients with PB-mpMRI lesions underwent “cognitive-targeted” plus systematic TRPB. Patients without lesions underwent systematic TRPB.</p> <h4>Results</h4> <p>Cohort B comprised younger (68 v 69 years, p=0.01) men with lower PSA (7.6 v 7.9 ng/mL, p=0.024) and prostate volume (56.1 v 62cc, p=0.006). There was no increase in overall PCa detection (57.6 v 56.7%, p=0.701), Gleason grade group (GGG), or number of positive cores (p>0.05 for each) in Cohort B versus Cohort A. Increased multi-focal prostatic intraepithelial neoplasia, maximum PCa core length (≥5mm versus <5mm), and radical surgery/HIFU (p<0.05 for each) was observed in Cohort B. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of a “negative” PB-mpMRI for GGG 2-5 PCa were 88.1%, 59.8%, 67.8% and 84% respectively. For “negative” PB-mpMRIs, a PSAd≥0.15 cut-point only increased “clinically significant” PCa detection if the latter was defined as GGG 3-5 disease and/or tumor length ≥6mm.</p> <h4>Conclusions</h4> <p>Introducing PB-mpMRI in our clinical setting increased the diagnostic yield of PCa per biopsy core. Not performing a systematic TRPB when the PB-mpMRI was "negative" would have led to under-detection of 15.1% (approximately 1 in 6) of GGG≥2 PCa cases.</p> |
| spellingShingle | Bryant, R Hobbs, C Eyre, K Davies, L Sullivan, M Shields, W Sooriakumaran, P Verrill, C Gleeson, F Macpherson, R Hamdy, F Brewster, S Comparison of prostate biopsy with or without pre-biopsy multi-parametric MRI in prostate cancer detection: an observational cohort study |
| title | Comparison of prostate biopsy with or without pre-biopsy multi-parametric MRI in prostate cancer detection: an observational cohort study |
| title_full | Comparison of prostate biopsy with or without pre-biopsy multi-parametric MRI in prostate cancer detection: an observational cohort study |
| title_fullStr | Comparison of prostate biopsy with or without pre-biopsy multi-parametric MRI in prostate cancer detection: an observational cohort study |
| title_full_unstemmed | Comparison of prostate biopsy with or without pre-biopsy multi-parametric MRI in prostate cancer detection: an observational cohort study |
| title_short | Comparison of prostate biopsy with or without pre-biopsy multi-parametric MRI in prostate cancer detection: an observational cohort study |
| title_sort | comparison of prostate biopsy with or without pre biopsy multi parametric mri in prostate cancer detection an observational cohort study |
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