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Minerva Urology and Nephrology 2021 Mar 26

DOI: 10.23736/S2724-6051.20.03758-3

Copyright © 2020 EDIZIONI MINERVA MEDICA

lingua: Inglese

Diagnostic performance of MRI/TRUS fusion-guided biopsies vs. systematic prostate biopsies in biopsy-naïve, previous negative biopsy patients and men undergoing active surveillance

Marco BORGHESI 1, Lorenzo BIANCHI 1, 2 , Umberto BARBARESI 1, Valerio VAGNONI 1, Beniamino CORCIONI 3, Caterina GAUDIANO 3, Michelangelo FIORENTINO 4, 5, Francesca GIUNCHI 4, Francesco CHESSA 1, 2, Marco GAROFALO 1, 2, Alessandro BERTACCINI 1, 2, Stefano ANGELINI 6, Amelio ERCOLINO 1, Carlo CASABLANCA 1, Matteo DROGHETTI 1, Rita GOLFIERI 3, Riccardo SCHIAVINA 1, 2

1 Department of Urology, S.Orsola-Malpighi University Hospital, Bologna, Italy; 2 Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Cardio-Nephro-Thoracic Sciences Doctorate, University of Bologna, Bologna, Italy; 3 Department of Radiology, S.Orsola-Malpighi University Hospital, Bologna, Italy; 4 Pathology Unit, S.Orsola-Malpighi University Hospital, Bologna, Italy; 5 Department of Pathology, C.A. Pizzardi-Maggiore Hospital, Bologna, Italy; 6 Hematology Department, G. e C. Mazzoni Hospital, Ascoli Piceno, Italy


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BACKGROUND: We aimed to assess the detection rate of overall PCa and csPCa, and the clinical impact of MRI/TRUS fusion targeted biopsy (FUSION-TB) compared to TRUS guided systematic biopsy (SB) in patients with different biopsy settings.
METHODS: 305 patients were submitted to FUSION-TB, divided into three groups: biopsy naïve patients, previous negative biopsies and patients under active surveillance (AS). All patients had a single suspicious index lesion at mpMRI. Within these groups, we enrolled men underwent both to FUSION-TB and SB in the same session. Overall detection rate of PCa and csPCa for the two biopsy methods were compared separately between the three groups of patients.
RESULTS: No differences were observed between the three groups concerning clinical and radiological characteristics. We found no differences in terms of overall PCa detection (66 % vs. 63,8 %, p=0,617) and csPCa detection (56,4 % vs. 51,1 %; p=0,225) concerning biopsy naïve patients. In patients previously submitted to a negative biopsy, FUSION-TB showed higher detection rate of csPCa compared to SB alone (41,3 % vs 27 % respectively, p=0.038). In patients under AS, no differences were observed between FUSION-TB and SB in terms of overall PCa (50 % vs. 73,1 %) and csPCa (30,8 % vs. 26,9 %, respectively; p=0,705) detection.
CONCLUSIONS: Our results suggest that in men with previously negative biopsy, FUSION-TB showed significantly higher diagnostic performance for clinically significant PCa as compared to SB. Combination of FUSION-TB and SB should be recommended in AS population to offer higher chance of csPCa diagnosis.


KEY WORDS: Clinically significant prostate cancer; Targeted biopsy; Fusion biopsy; Detection rate; Clinical impact

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