Diagnostic accuracy of transperineal MRI fusion biopsy in comparison to transrectal biopsy with regard to incidental histopathological findings in transurethral resection of the prostate

• Verfasst von: Dieffenbacher, Svenja [VerfasserIn]
• Verfasst von: Popeneciu, Valentin [VerfasserIn]
• Verfasst von: Radtke, Jan Philipp [VerfasserIn]
• Verfasst von: Teber, Dogu [VerfasserIn]
• Verfasst von: Hohenfellner, Markus [VerfasserIn]
• Verfasst von: Hadaschik, Boris [VerfasserIn]
• Verfasst von: Hatiboglu, Gencay [VerfasserIn]
• Titel: Diagnostic accuracy of transperineal MRI fusion biopsy in comparison to transrectal biopsy with regard to incidental histopathological findings in transurethral resection of the prostate
• Verf.angabe: Svenja Christina Dieffenbacher, Ionel Valentin Popeneciu, Jan Philipp Radtke, Dogu Teber, Markus Hohenfellner, Boris Alexander Hadaschik, Gencay Hatiboglu
• E-Jahr: 2017
• Jahr: September 2017
• Umfang: 6 S.
• Fussnoten: Gesehen am 12.11.2018
• Titel Quelle: Enthalten in: Urologia internationalis
• Ort Quelle: Basel : Karger, 1955
• Jahr Quelle: 2017
• Band/Heft Quelle: 99(2017), 2, Seite 162-167
• ISSN Quelle: 1423-0399
• DOI: doi:10.1159/000456078
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1583627294

Abstract

<b><i>Objective:</i></b> To investigate the diagnostic accuracy of transperineal MRI/transrectal ultrasound (TRUS) fusion prostate biopsy vs. transrectal prostate biopsy in transurethral resection (TUR) specimen of men undergoing TUR of the prostate (TURP) for symptomatic bladder outlet obstruction. <b><i>Material and Methods:</i></b> From a database of 3,509 men receiving prostate biopsy, all those undergoing TURP and negative prostate biopsy (<i>n</i> = 95; 45 transrectal, 50 transperineal fusion) were analysed. TURP specimens were compared with regard to incidental prostate cancer. <b><i>Results:</i></b> Pre- and peri-interventional parameters in transrectal vs. fusion biopsy groups for age (65.2 ± 7.8 vs. 65.5 ± 7.3 years; <i>p</i> = 0.84), prostate specific antigen (10.7 ± 8.5 vs. 10.9 ± 8.7 ng/mL; <i>p</i> = 0.93), preoperative prostate volume (72.5 ± 26.1 vs. 71.8 ± 28.1 mL; <i>p</i> = 0.91) and resected weight (43.7 ± 21.9 vs. 41.4 ± 20.7 g; <i>p</i> = 0.61) showed no significant differences. Analysing the TURP specimen, 5 incidental T1a prostate cancers were found (3 Gleason 3 + 3 = 6; 2 Gleason 3 + 4 = 7, all in the transrectal biopsy group). Although, more biopsy cores were obtained in the MRI/TRUS fusion biopsy group (26 cores [interquartile range, IQR 24-28] vs. 14 cores [IQR 12-24], <i>p</i> < 0.01), there was no statistical impact of the obtained number of cores (<i>p</i> = 0.9) on diagnostic accuracy. Statistical analyses revealed significantly better diagnostic accuracy favoring image-guided fusion biopsy (<i>p</i> = 0.02). <b><i>Conclusions:</i></b> Our findings showed that a combination of MRI-targeted and systematic transperineal prostate biopsy improves patient safety. This is associated with a combination of transperineal biopsy technique and pre-interventional MRI.