Abstract
Objective
To evaluate the learning curve (LC) of two urology residents in the execution of fusion
biopsy (FB) in terms of overall prostate cancer (PCa) and clinically significant (cs)
PCa detection rate (DR) and according to different characteristics of the lesions
on MRI
Material and Methods
We analyzed data from our prospective maintained FB database between January 2015
and December 2019. FB was performed using the BioJet fusion system (D&K Technologies,
Barum, Germany) with a transrectal or transperineal approach. An ANOVA test was used
to evaluate the homogeneity of our cohort. Multivariable linear and logistic regression
analysis were used to evaluate the relationship between operator experience and DR
for PCa and csPCa. Then, the postprocedural complication rate trend was evaluated.
Results
1005 patients were included. The overall DR of PCa was 61.2% (615/1005) [IC 0.58 –
0.64]; whilst DR for csPCA was 54.6% (549/1005) [IC 0.51 – 0.57]. Operator experience
does not seem to influence the DR of overall PCa and csPCa; whilst for lesions <8
mm in diameter, PCa and csPCa DR increased significantly with operator experience
(P = 0.048 and P = 0.038, respectively). Postprocedural complications remained stable during the whole
study period (P = 0.75).
Conclusion
A standardized FB approach turned out to be feasible, safe, and effective since the
beginning of the residents’ LC. PCa and csPCa DR remained stable, at 60% and 55% respectively,
after more than 1,000 biopsies. However, for lesions smaller than 8 mm, at least 100
FB of experience is needed to correctly sample the area.
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Article info
Publication history
Published online: July 01, 2021
Accepted:
June 21,
2021
Received:
March 19,
2021
Footnotes
Financial Disclosure: The authors have no disclosures or conflicts of interest.
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
