Initial experience and cancer detection rates of office-based transperineal magnetic resonance imaging-ultrasound fusion prostate biopsy under local anesthesia

Authors

  • Zachary Kozel Arthur Smith Institute for Urology, Zucker School of Medicine at Hofstra/Northwell. New Hyde Park, NY.
  • Clay Martin Arthur Smith Institute for Urology, Zucker School of Medicine at Hofstra/Northwell. New Hyde Park, NY.
  • David Mikhail Lenox Hill Hospital, Northwell Health https://orcid.org/0000-0003-4814-6095
  • Aaron Smith Arthur Smith Institute for Urology, Zucker School of Medicine at Hofstra/Northwell. New Hyde Park, NY.
  • Luke Griffiths Arthur Smith Institute for Urology, Zucker School of Medicine at Hofstra/Northwell. New Hyde Park, NY.
  • Daniel Nethala Arthur Smith Institute for Urology, Zucker School of Medicine at Hofstra/Northwell. New Hyde Park, NY.
  • Manish Vira Arthur Smith Institute for Urology, Zucker School of Medicine at Hofstra/Northwell. New Hyde Park, NY.
  • Michael Schwartz Arthur Smith Institute for Urology, Zucker School of Medicine at Hofstra/Northwell. New Hyde Park, NY.

DOI:

https://doi.org/10.5489/cuaj.7472

Keywords:

transperineal biopsy, prostate biopsy, MRI-fusion biopsy, Prostate Cancer Detection, Office Biopsy

Abstract

Introduction: We aimed to demonstrate feasibility and cancer detection rates of office-based ultrasound-guided transperineal magnetic resonance imaging-ultrasound (MRI-US) fusion (TFB) prostate biopsy under local anesthesia.

Methods: With institutional review board approval, records of men undergoing TFB in the office setting under local anesthesia were reviewed. Baseline patient characteristics, MRI findings, cancer detection rates, and complications were recorded. The PrecisionPoint Transperineal Access System (Perineologic, Cumberland, MD, U.S.), along with UroNav 3.0 image-fusion system (Invivo International, Best, The Netherlands) were used for all procedures. Following biopsy, men were surveyed to assess patient experience.

Results: Between January 2019 and February 2020, 200 TFBs were performed, of which 141 (71%) were positive for prostate cancer, with 117 (83%) Gleason grade group 2 or higher. A total of 259 of 265 MRI lesions were biopsied, with 127 (49%) positive overall. Prostate Imaging–Reporting and Data System (PI-RADS) 4–5 lesions were positive for prostate cancer in 59% of cases. The mean procedural time was 20 minutes, with a patient enter-to-exit room time of 54 minutes. There were no septic complications, no patients required post-procedure hospital admission, and all procedures were successfully completed. Seventy-five percent of patients surveyed reported complete resolution of pain at three days following the procedure.

Conclusions: Office-based TFB represents a viable approach to prostate cancer detection following prostate MRI. Larger-scale assessment is needed to categorize cancer detection rates more accurately by PI-RADs subset, patient selection factors, complication rate, and cost relative to TFB under anesthesia.

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Published

2022-02-28

How to Cite

Kozel, Z., Martin, C., Mikhail, D., Smith, A., Griffiths, L., Nethala, D., Vira, M., & Schwartz, M. (2022). Initial experience and cancer detection rates of office-based transperineal magnetic resonance imaging-ultrasound fusion prostate biopsy under local anesthesia. Canadian Urological Association Journal, 16(7), E350–6. https://doi.org/10.5489/cuaj.7472

Issue

Vol. 16 No. 7 (2022): CUAJ July

Section

Original Research

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