MP81-07 COMPARISON OF SYSTEMATIC 12-CORE PROSTATE BIOPSY AND MAGNETIC RESONANCE IMAGING FUSION PROSTATE BIOPSY TO THE FINAL SURGICAL PATHOLOGY

You have accessJournal of UrologyProstate Cancer: Detection & Screening VIII (MP81)1 Apr 2020MP81-07 COMPARISON OF SYSTEMATIC 12-CORE PROSTATE BIOPSY AND MAGNETIC RESONANCE IMAGING FUSION PROSTATE BIOPSY TO THE FINAL SURGICAL PATHOLOGY Isaac Palma-Zamora, Akshay Sood, Guillaume Farah*, Philip Olson, Deepansh Dalela, Sohrab Arora, Marcus Jamil, Natalija Kovacevic, Grace Yaguchi, Jacob Keeley, James O. Peabody, Craig G. Rogers, Mani Menon, Ali Dabaja, and Firas Abdollah Isaac Palma-ZamoraIsaac Palma-Zamora More articles by this author , Akshay SoodAkshay Sood More articles by this author , Guillaume Farah*Guillaume Farah* More articles by this author , Philip OlsonPhilip Olson More articles by this author , Deepansh DalelaDeepansh Dalela More articles by this author , Sohrab AroraSohrab Arora More articles by this author , Marcus JamilMarcus Jamil More articles by this author , Natalija KovacevicNatalija Kovacevic More articles by this author , Grace YaguchiGrace Yaguchi More articles by this author , Jacob KeeleyJacob Keeley More articles by this author , James O. PeabodyJames O. Peabody More articles by this author , Craig G. RogersCraig G. Rogers More articles by this author , Mani MenonMani Menon More articles by this author , Ali DabajaAli Dabaja More articles by this author , and Firas AbdollahFiras Abdollah More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000973.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Transrectal ultrasound guided (TRUS) prostate biopsies are the standard of care for the diagnosis of prostate cancer (PCa). However, magnetic resonance imaging (MRI) has the ability to enhance the diagnostic potential of TRUS biopsies. Our study aims to compare biopsy pathological grading of TRUS prostate systematic 12-core biopsy and MRI Fusion biopsy (MFB) to the final surgical pathology of radical prostatectomy specimens. METHODS: We examined a total of 221 patients who underwent MFB between October 2015 and August 2019. All patients underwent a double sextant 12-core biopsy along with biopsies of targeted lesions during the same procedure. A total of 126 patients underwent prostate biopsy for diagnostic indications, of which 42 went on to have a radical prostatectomy. Gleason scores from double sextant 12-core specimen were compared to those of regions of interest on MRI, and to the final pathology specimen where appropriate, as proxies for the TRUS and MFB approaches. Upgrading was defined as Gleason score 6 on biopsy, which showed a pathological score of 3+4 or above, while downgrading was the reverse. A chi-squared test was used to assess statistical significance. RESULTS: Median (IQR) age and PSA were 65 (60-69) years and 6.1 (4.4-9.0) ng/ml, respectively. A total of 76 patients had a positive biopsy result, of whom 42 underwent radical prostatectomy. Overall, PCa detection was higher in the MFB vs TRUS approach, albeit this finding was not statistically significant (48% vs 37%, p=0.06). Of the 42 patients that underwent surgery, 38 had a positive MFB compared to 27 in TRUS (90% vs 64%, p=0.004). The final pathological score coincided with TRUS and MFB 56% and 61% of the time (p=0.69), respectively. MFB had a higher rate of upgrading (13% vs 11%) and downgrading (33% vs 26%), but this was not statistically significant (p=0.66). CONCLUSIONS: Improved PCa detection by MFB approached statistical significance in patients undergoing a biopsy for diagnostic purposes. In those diagnosed with PCa, the detection rate with final pathology was superior in the MFB cohort. However, the discordance between MFB and final pathology questions its perceived superiority over TRUS, as both appear to be similarly accurate. Source of Funding: None. © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e1238-e1239 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Isaac Palma-Zamora More articles by this author Akshay Sood More articles by this author Guillaume Farah* More articles by this author Philip Olson More articles by this author Deepansh Dalela More articles by this author Sohrab Arora More articles by this author Marcus Jamil More articles by this author Natalija Kovacevic More articles by this author Grace Yaguchi More articles by this author Jacob Keeley More articles by this author James O. Peabody More articles by this author Craig G. Rogers More articles by this author Mani Menon More articles by this author Ali Dabaja More articles by this author Firas Abdollah More articles by this author Expand All Advertisement PDF downloadLoading ...