Objective
To determine how ipsilateral (ipsi) and contralateral (contra) systematic biopsies
(SB) impact detection of clinically significant vs insignificant prostate cancer (PCa)
in men with unilateral magnetic resonance imaging (MRI) lesion undergoing MRI-ultrasound
fusion-targeted biopsy (MRF-TB).
Materials and Methods
A total of 211 cases with 1 unilateral MRI lesion were subjected to SB and MRF-TB.
Biopsy tissue cores from the MRF-TB, ipsi-SB, and contra-SB were analyzed separately.
Results
A direct relationship was observed between MRI suspicion score and (1) detection of
any cancer, (2) Gleason 6 PCa, and (3) Gleason >6 PCa. MRF-TB alone, MRF-TB + ipsi-SB,
and MRF-TB + contra-SB detected 64.1%, 89.1%, and 76.1% of all PCa, respectively;
53.5%, 81.4%, and 69.8% of Gleason 6 PCa, respectively; and 73.5%, 96.0%, and 81.6%
of Gleason >6 PCa, respectively. MRF-TB + ipsi-SB detected 96% of clinically significant
PCa and avoided detection of 18.6% of clinically insignificant PCa. MRF-TB + contra-SB
detected 81.6% of clinically significant PCa and avoided detection of 30.2% of clinically
insignificant PCa.
Conclusion
Our study suggests that ipsi-SB should be added to MRF-TB, as detection of clinically
significant PCa increases with only a modest increase in clinically insignificant
PCa detection. Contra-SB in this setting may be deferred because it primarily detects
clinically insignificant PCa.
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Article info
Publication history
Published online: November 18, 2016
Accepted:
November 11,
2016
Received:
August 24,
2016
Footnotes
Financial Disclosure: The authors declare that they have no relevant financial interests.
Identification
Copyright
© 2016 Published by Elsevier Inc.
