Assessment of the Minimal Targeted Biopsy Core Number per MRI Lesion for Improving Prostate Cancer Grading Prediction

Journal of Clinical Medicine - Tập 9 Số 1 - Trang 225
Guillaume Ploussard1,2, Jean‐Baptiste Beauval2, Raphaële Renard‐Penna3, M. Lesourd4,1, C. Manceau4, C. Alméras2, Jean‐Romain Gautier2, Guillaume Loison2, D. Portalez5, Ambroise Salin2, M. Soulié4, Christophe Tollon2, Bernard Malavaud4,1, M. Roumiguié4,1
1Department of Urology, Institut Universitaire du Cancer Toulouse—Oncopole, 31000 Toulouse, France
2Department of Urology, La Croix du Sud Hospital, 52, chemin de Ribaute, 31130 Quint Fonsegrives, France
3Department of Radiology, CHU La Pitié Salpétrière/Tenon, Sorbonne Université, 75005 Paris, France
4Department of Urology, CHU Toulouse, 31000 Toulouse, France
5Department of Radiology, Institut Universitaire du Cancer Toulouse—Oncopole, 31000 Toulouse, France

Tóm tắt

Background: To study the impact of MRI characteristics and of targeted biopsy (TB) core number on the final grade group (GG) prediction. Materials and Methods: The cohort was 478 consecutive patients who underwent radical prostatectomy (RP) after positive mpMRI (multiparametric magnetic resonance imaging) followed by fusion TB. Endpoints were the upgrading and concordance rates between TB and RP specimens. Results: Upgrading rate after TB was 40.6%. Patients with upgrading had lower PIRADS (Prostate Imaging-Reporting and Data System) scores (p < 0.001), smaller lesion size (p = 0.017), fewer TB cores (p < 0.001), and lower TB density (p = 0.015) compared with cases with grade concordance. There was a significant continuous improvement in upgrading rate when TB core number per lesion increased from 56.3% to 25.6% when <2 or ≥5 TB cores were taken, respectively (p = 0.002). The minimal TB number per lesion to reduce upgrading risk to approximately 30%was 4 in PIRADS 3, and 3 in PIRADS 4–5 cases. Conclusions: Grade group prediction by TB is significantly improved by higher PIRADS score, larger lesion size, and increased TB per lesion. At least four TB cores should be taken in PIRADS 3 score lesions, whereas three cores seem enough in PIRADS 4–5 cases to improve GG prediction and limit upgrading risk.

Từ khóa


Tài liệu tham khảo

Mottet, 2017, EAU-ESTRO-SIOG Guidelines on Prostate Cancer. Part 1: Screening, Diagnosis, and Local Treatment with Curative Intent, Eur. Urol., 71, 618, 10.1016/j.eururo.2016.08.003

Kasivisvanathan, 2018, MRI-Targeted or Standard Biopsy for Prostate-Cancer Diagnosis, N. Engl. J. Med., 378, 1767, 10.1056/NEJMoa1801993

Siddiqui, 2016, Efficiency of Prostate Cancer Diagnosis by MR/Ultrasound Fusion-Guided Biopsy vs Standard Extended-Sextant Biopsy for MR-Visible Lesions, J. Natl. Cancer Inst., 108, djw039, 10.1093/jnci/djw039

Cornel, 2019, Head-to-head Comparison of Transrectal Ultrasound-guided Prostate Biopsy Versus Multiparametric Prostate Resonance Imaging with Subsequent Magnetic Resonance-guided Biopsy in Biopsy-naïve Men with Elevated Prostate-specific Antigen: A Large Prospective Multicenter Clinical Study, Eur. Urol., 75, 570, 10.1016/j.eururo.2018.11.023

Puech, 2019, Use of prostate systematic and targeted biopsy on the basis of multiparametric MRI in biopsy-naive patients (MRI-FIRST): A prospective, multicentre, paired diagnostic study, Lancet Oncol., 20, 100, 10.1016/S1470-2045(18)30569-2

Dimitroulis, 2018, Multiparametric magnetic resonance imaging/ultrasound fusion prostate biopsy: Are 2 biopsy cores per magnetic resonance imaging lesion required?, J. Urol., 200, 1030, 10.1016/j.juro.2018.05.002

Lu, A.J., Syed, J.S., Ghabili, K., Hsiang, W.R., Nguyen, K.A., Leapman, M.S., and Sprenkle, P.C. (2019). Role of Core Number and Location in Targeted Magnetic Resonance Imaging- Ultrasound Fusion Prostate Biopsy. Eur. Urol.

Schouten, 2017, Why and Where do We Miss Significant Prostate Cancer with Multi-parametric Magnetic Resonance Imaging followed by Magnetic Resonance-guided and Transrectal Ultrasound-guided Biopsy in Biopsy-naïve Men?, Eur. Urol., 71, 896, 10.1016/j.eururo.2016.12.006

Diamand, R., Oderda, M., Obeid, W.A.H., Albisinni, S., Van Velthoven, R., Fasolis, G., Simone, G., Ferriero, M., Roche, J.B., and Piechaud, T. (2019). A multicentric study on accurate grading of prostate cancer with systematic and MRI/US fusion targeted biopsies: Comparison with final histopathology after radical prostatectomy. World J. Urol.

Ploussard, G., Borgmann, H., Briganti, A., De Visschere, P., Fütterer, J.J., Gandaglia, G., Heidegger, I., Kretschmer, A., Mathieu, R., and Ost, P. (2018). Positive pre-biopsy MRI: Are systematic biopsies still useful in addition to targeted biopsies?. World J. Urol.

Gold, S.A., Hale, G.R., Bloom, J.B., Smith, C.P., Rayn, K.N., Valera, V., Wood, B.J., Choyke, P.L., Turkbey, B., and Pinto, P.A. (2018). Follow-up of negative MRI-targeted prostate biopsies: When are we missing cancer?. World J. Urol.

Radtke, 2016, Multiparametric Magnetic Resonance Imaging (MRI) and MRI-Transrectal Ultrasound Fusion Biopsy for Index Tumor Detection: Correlation with Radical Prostatectomy Specimen, Eur. Urol., 70, 846, 10.1016/j.eururo.2015.12.052

Le, 2015, Multifocality and prostate cancer detection by multiparametric magnetic resonance imaging: Correlation with whole-mount histopathology, Eur. Urol., 67, 569, 10.1016/j.eururo.2014.08.079

Barentsz, 2012, ESUR prostate MR guidelines 2012, Eur. Radiol., 22, 746, 10.1007/s00330-011-2377-y

Barentsz, 2016, Synopsis of the PI-RADS v2 guidelines for multiparametric prostate magnetic resonance imaging and recommendations for use, Eur. Urol., 69, 41, 10.1016/j.eururo.2015.08.038

Westhoff, 2017, Precision of MRI/ultrasound-fusion biopsy in prostate cancer diagnosis: An ex vivo comparison of alternative biopsy techniques on prostate phantoms, World J. Urol., 35, 1015, 10.1007/s00345-016-1967-3

Ploussard, 2019, Added Value of Concomitant Systematic and Fusion Targeted Biopsies for Grade Group Prediction Based on Radical Prostatectomy Final Pathology on Positive Magnetic Resonance Imaging, J. Urol., 202, 1182, 10.1097/JU.0000000000000418

Wibulpolprasert, P., Raman, S.S., Hsu, W., Margolis, D.J., Asvadi, N.H., Khoshnoodi, P., Moshksar, A., Tan, N., Ahuja, P., and Maehara, C.K. (2019). Detection and Localization of Prostate Cancer at 3-T Multiparametric MRI Using PI-RADS Segmentation. Am. J. Roentgenol.

Covin, B., Roumiguié, M., Quintyn-Ranty, M.L., Graff, P., Khalifa, J., Aziza, R., Ploussard, G., Portalez, D., and Malavaud, B. (2018). Refining the risk-stratification of transrectal biopsy-detected prostate cancer by elastic fusion registration transperineal biopsies. World J. Urol.

Cornud, 2018, Precision Matters in MR Imaging-targeted Prostate Biopsies: Evidence from a Prospective Study of Cognitive and Elastic Fusion Registration Transrectal Biopsies, Radiology, 287, 534, 10.1148/radiol.2017162916

Thông tin
Thông tin xuất bản

Journal of Clinical Medicine

Tập 9 Số 1

225

Thông tin tác giả