Christian Arsov1, Robert Rabenalt2, Michael Quentin3, Andreas Hiester4, Dirk Blondin5, Peter Albers6, Gerald Antoch7, Lars Schimmöller8. 1. Department of Urology, Medical Faculty, University of Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany. christian.arsov@med.uni-duesseldorf.de. 2. Department of Urology, Medical Faculty, University of Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany. Robert.Rabenalt@med.uni-duesseldorf.de. 3. Department of Diagnostic and Interventional Radiology, Medical Faculty, University of Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany. Michael.Quentin@med.uni-duesseldorf.de. 4. Department of Urology, Medical Faculty, University of Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany. Andreas.Hiester@med.uni-duesseldorf.de. 5. Department of Diagnostic and Interventional Radiology, Medical Faculty, University of Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany. Dirk.Blondin@sk-mg.de. 6. Department of Urology, Medical Faculty, University of Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany. urologie@uni-duesseldorf.de. 7. Department of Diagnostic and Interventional Radiology, Medical Faculty, University of Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany. Antoch@med.uni-duesseldorf.de. 8. Department of Diagnostic and Interventional Radiology, Medical Faculty, University of Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany. Lars.Schimmoeller@med.uni-duesseldorf.de.
Abstract
PURPOSE: The objective of this study was to compare patient comfort between MR-guided in-bore prostate biopsy (IB-GB) and MRI/ultrasound fusion-guided prostate biopsy (FUS-GB) with additional systematic 12-core transrectal ultrasound (TRUS)-guided biopsy within a prospective randomized trial. METHODS:Two hundred and ten consecutive patients were randomly assigned in a 1:1 ratio to receive either IB-GB and prior intrarectal instillation of a 2% lidocaine gel (n = 106) or FUS-GB plus additional systematic 12-core TRUS-guided biopsy and prior application of a periprostatic nerve block (PPNB) with 2% mepivacaine (n = 104). The maximal procedural pain (MPP) on a 0-10 visual analog scale and the operating room time were recorded for each biopsy session. RESULTS:Baseline characteristics and mean number of targeted biopsy cores (5.6 ± 0.8 vs 5.4 ± 1.2 for IB-GB and FUS-GB, respectively; p = 0.278) were similar in both study arms. In relation to the IB-GB arm, the total number of biopsy cores in the FUS-GB arm, including the systematic 12-core TRUS-guided biopsy, was significantly higher (17.4 ± 1.2; p < 0.001). Patients with IB-GB had significantly higher MPP scores (2.95 ± 2.15) compared with subjects with FUS-GB (1.95 ± 1.56; p < 0.001). FUS-GB required significantly less time (28.22 ± 11.61 min) in comparison with IB-GB (42.09 ± 11.37 min; p < 0.001). CONCLUSIONS: The PPNB can easily be administered just prior to performing FUS-GB. Thus, patients have significantly lower pain levels in comparison with IB-GB, which is usually done with intrarectal anesthetic gels. Although the addition of a systematic 12-core TRUS-guided biopsy significantly increases the number of biopsy cores, FUS-GB still requires significantly less time in comparison with IB-GB.
RCT Entities:
PURPOSE: The objective of this study was to compare patient comfort between MR-guided in-bore prostate biopsy (IB-GB) and MRI/ultrasound fusion-guided prostate biopsy (FUS-GB) with additional systematic 12-core transrectal ultrasound (TRUS)-guided biopsy within a prospective randomized trial. METHODS: Two hundred and ten consecutive patients were randomly assigned in a 1:1 ratio to receive either IB-GB and prior intrarectal instillation of a 2% lidocaine gel (n = 106) or FUS-GB plus additional systematic 12-core TRUS-guided biopsy and prior application of a periprostatic nerve block (PPNB) with 2% mepivacaine (n = 104). The maximal procedural pain (MPP) on a 0-10 visual analog scale and the operating room time were recorded for each biopsy session. RESULTS: Baseline characteristics and mean number of targeted biopsy cores (5.6 ± 0.8 vs 5.4 ± 1.2 for IB-GB and FUS-GB, respectively; p = 0.278) were similar in both study arms. In relation to the IB-GB arm, the total number of biopsy cores in the FUS-GB arm, including the systematic 12-core TRUS-guided biopsy, was significantly higher (17.4 ± 1.2; p < 0.001). Patients with IB-GB had significantly higher MPP scores (2.95 ± 2.15) compared with subjects with FUS-GB (1.95 ± 1.56; p < 0.001). FUS-GB required significantly less time (28.22 ± 11.61 min) in comparison with IB-GB (42.09 ± 11.37 min; p < 0.001). CONCLUSIONS: The PPNB can easily be administered just prior to performing FUS-GB. Thus, patients have significantly lower pain levels in comparison with IB-GB, which is usually done with intrarectal anesthetic gels. Although the addition of a systematic 12-core TRUS-guided biopsy significantly increases the number of biopsy cores, FUS-GB still requires significantly less time in comparison with IB-GB.
Authors: L Schimmöller; M Quentin; C Arsov; R S Lanzman; A Hiester; R Rabenalt; G Antoch; P Albers; D Blondin Journal: Eur Radiol Date: 2013-06-12 Impact factor: 5.315
Authors: Peter A Pinto; Paul H Chung; Ardeshir R Rastinehad; Angelo A Baccala; Jochen Kruecker; Compton J Benjamin; Sheng Xu; Pingkun Yan; Samuel Kadoury; Celene Chua; Julia K Locklin; Baris Turkbey; Joanna H Shih; Stacey P Gates; Carey Buckner; Gennady Bratslavsky; W Marston Linehan; Neil D Glossop; Peter L Choyke; Bradford J Wood Journal: J Urol Date: 2011-08-17 Impact factor: 7.450
Authors: Thomas Hambrock; Diederik M Somford; Caroline Hoeks; Stefan A W Bouwense; Henkjan Huisman; Derya Yakar; Inge M van Oort; J Alfred Witjes; Jurgen J Fütterer; Jelle O Barentsz Journal: J Urol Date: 2009-12-14 Impact factor: 7.450
Authors: Joyce G R Bomers; Derya Yakar; Christiaan G Overduin; J P Michiel Sedelaar; Henk Vergunst; Jelle O Barentsz; Frank de Lange; Jurgen J Fütterer Journal: Radiology Date: 2013-03-22 Impact factor: 11.105
Authors: L Schimmöller; M Quentin; D Blondin; F Dietzel; A Hiester; C Schleich; C Thomas; R Rabenalt; H E Gabbert; P Albers; G Antoch; C Arsov Journal: Eur Radiol Date: 2016-02-26 Impact factor: 5.315
Authors: Sadhna Verma; Peter L Choyke; Steven C Eberhardt; Aytekin Oto; Clare M Tempany; Baris Turkbey; Andrew B Rosenkrantz Journal: Radiology Date: 2017-11 Impact factor: 11.105
Authors: M Quentin; C Arsov; T Ullrich; B Valentin; A Hiester; D Blondin; P Albers; G Antoch; L Schimmöller Journal: Eur Radiol Date: 2019-06-27 Impact factor: 5.315
Authors: Emanuel Darius Cata; Charles Van Praet; Iulia Andras; Pierre Kadula; Razvan Ognean; Maximilian Buzoianu; Daniel Leucuta; Cosmin Caraiani; Attila Tamas-Szora; Karel Decaestecker; Ioan Coman; Nicolae Crisan Journal: Transl Androl Urol Date: 2021-05