Success of targeted transperineal biopsy in patients on surveillance for grade group 1 prostate cancer

Authors

  • Kevin Martell University of Calgary
  • Hans Chung Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto
  • Gerard Morton Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto
  • Danny Vesprini Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto
  • Chia-Lin Tseng Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto
  • Ewa Szumacher Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto
  • Patrick Cheung Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto
  • Will Chu Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto
  • Stanley Liu Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto
  • Andrew Loblaw Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto

DOI:

https://doi.org/10.5489/cuaj.7752

Keywords:

prostate cancer, targeted biopsy, transperineal biopsy

Abstract

Introduction: We aimed to determine the minimum cross-sectional ellipsoid area on magnetic resonance (MR) of intraprostatic nodules that best predicts for subsequent targeted biopsies revealing ≥ grade group (GG) 2 disease.

Methods: Forty-six patients previously diagnosed with GG 1 prostate adenocarcinoma who received cognitively fused, MR-guided, transperineal targeted biopsies in addition to six random biopsies were included in this analysis. A Youden cutpoint analysis was used to determine the ellipsoid area in the axial plane best predicting for ≥GG 2 disease within the targeted biopsy cores and logistic regression used to assess the result.

Results: Median time from MR imaging to targeted biopsy was 2.4 (1.4–5.5) months. Forty of 46 (87%) patients had one nodule and 6/46 (13%) had two separate nodules on MR that received targeted biopsy. Of the 52 nodules, five (10%), 33 (63%), and 14 (27%) were Prostate Imaging–Reporting and Data System (PI-RADS) 3, 4, and 5. Thirteen (25%), six (12%), and 33 (64%) were in the anterior, medial, and posterior regions of the prostate. Median area was 0.72 (0.49–1.29) cm2 (average diameter 9.5 mm). Fifteen of 46 (33%) patients had ≥1 random biopsy and 20/52 (38%) nodules had ≥1 targeted biopsy revealing ≥GG 2 disease. The optimal area cutpoint was ≥0.7cm2, with an area under the curve of 0.671 (0.510–0.832). On logistic regression, areas ≥0.7 cm2 was solely predictive of targeted biopsy revealing ≥GG 2 disease (odds ratio 6.5, 1.3–32.4, p=0.022).

Conclusions: Nodule area ≥0.7 cm2 may predict for transperineal-based targeted biopsies being positive for ≥GG 2 disease when 1–2 cores are taken.

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Published

2022-03-11

How to Cite

Martell, K., Chung, H. ., Morton, G. ., Vesprini, D. ., Tseng, C.-L. ., Szumacher, E. ., Cheung, P. ., Chu, W. ., Liu, S. ., & Loblaw, A. . (2022). Success of targeted transperineal biopsy in patients on surveillance for grade group 1 prostate cancer. Canadian Urological Association Journal, 16(8). https://doi.org/10.5489/cuaj.7752

Issue

Section

Original Research