Prostate cancer detection rate with MRI-targeted biopsy alone using outpatient transperineal prostate biopsy

Authors

  • Pier Paolo Avolio McGill University
  • Toufic Hassan
  • Abdulmalik Addar
  • Hend Alshamsi
  • Victor McPherson
  • Oleg Loutochin
  • Giovanni Lughezzani
  • Nicolò Maria Buffi
  • Maurice Anidjar
  • Rafael Sanchez-Salas

DOI:

https://doi.org/10.5489/cuaj.8675

Keywords:

Prostate cancer; MRI-targeted biopsy; Trans-perineal biopsy; Local anesthesia; Systematic biopsy.

Abstract

INTRODUCTION: We aimed to compare the detection rate of prostate cancer (PCa) and clinically significant (cs) PCa by magnetic resonance imaging-guided targeted biopsy (MTBx) alone and MTBx plus systematic biopsy (SBx) using an outpatient transperineal (TP) approach under local anesthesia.

METHODS: A retrospective study of patients who underwent outpatient TP prostate biopsy under local anesthesia at our tertiary institution between 2019 and 2022 was performed. To compare the proportions of PCa and csPCa in both pathways, McNemar’s tests were used. Multivariable logistic regression model was fitted to determine the predictors of csPCa.

RESULTS: Of 255 men included, 177 (69%) underwent MTBx alone. MTBx had similar detection rate for PCa (56%) and csPCa (47%) compared to the combination of MTBx and SBx (PCa 61%; csPCa 49%; p=0.1 and p=0.3, respectively). MTBx had lower median number of biopsy cores compared to the combination of MTBx and SBx (6 vs. 11, p<0.001). At multivariable logistic regression analysis, age (odds ratio [OR] 1.08, 95% confidence interval [CI] 1.04–1.13, p<0.001), prior negative biopsy (OR 0.19, 95% CI 0.09–0.44, p<0.001), prostate-specific antigen density cutoff ≥0.15 (OR 3.17, 95% CI 1.67–6.01, p<0.001), and prostate imaging reporting and data system ≥4 (OR 12.2, 95% CI 4.21–35.6, p<0.001) were independent predictors of csPCa.

CONCLUSIONS: MTBx showed similar diagnostic performance to the combination of MTBx and SBx in patients undergoing outpatient TP prostate biopsy. Future studies are needed to evaluate the role of MTBx in avoiding unnecessary biopsies.

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Published

2024-06-17

How to Cite

Avolio, P. P., Hassan, T. ., Addar, A. ., Alshamsi, H. ., McPherson, V. ., Loutochin, O. ., … Sanchez-Salas, R. . (2024). Prostate cancer detection rate with MRI-targeted biopsy alone using outpatient transperineal prostate biopsy. Canadian Urological Association Journal, 18(11), E312–8. https://doi.org/10.5489/cuaj.8675

Issue

Vol. 18 No. 11 (2024): CUAJ November

Section

Original Research

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