Abstract
Objective
To compare the diagnostic performance of the 2 most common approaches of magnetic
resonance imaging targeted biopsy (TB)—cognitive registration targeted biopsy (COG-TB)
and software fusion targeted biopsy (FUS-TB)—we assessed our institutional experience
with both methods. TB has emerged to complement systematic template biopsy (SB) in
prostate cancer (PCa) diagnosis; however, which magnetic resonance imaging targeting
methodology is diagnostically better remains unclear.
Materials and methods
A total of 510 patients underwent TB at our institution before and after the adoption
of fusion software with the UroNav platform (Invivo Corporation, Gainsville, FL).
All patients had concurrent 12-core SB. We compared rates of clinically significant
PCa detection, and rates of upstaging and missed diagnosis in reference to SB among
patients who received COG-TB and patients who received FUS-TB. We also compared both
COG-TB and FUS-TB results to their paired SB results.
Results
The rates of upstaging or missing clinically significant PCa with FUS-TB (in reference
to SB) was not significantly different from COG-TB (P = 0.172), nor was the risk of missing clinically significant PCa different between
FUS-TB vs COG-TB on logistic regression ( Odds ratio = 0.55, P = 0.106). No significant difference in biopsy outcomes was observed between FUS-TB
and COG-TB (P = 0.171). We did find significant differences between FUS-TB and SB and between COG-TB
and SB, with SB finding more clinically insignificant PCa (P < 0.001 and P = 0.04).
Conclusion
In our institutional experience, no significant difference was observed between the
diagnostic ability of COG-TB vs FUS-TB for detecting clinically significant PCa. Greater
evidence demonstrating an advantage of FUS-TB over COG-TB would be required for clear
recommendations in favor of FUS-TB.
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Article info
Publication history
Published online: June 22, 2018
Accepted:
June 7,
2018
Received in revised form:
June 3,
2018
Received:
April 25,
2018
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
