Jonas Schiffmann1, Gisa Mehring2, Pierre Tennstedt3, Lukas Manka4, Katharina Boehm3,5, Sami-Ramzi Leyh-Bannurah2, Pierre I Karakiewicz5,6, Peter Hammerer4, Markus Graefen3, Georg Salomon3. 1. Department of Urology, Academic Hospital Braunschweig, Salzdahlumerstrasse 90, 38126, Brunswick, Germany. schiffmann.jonas@gmx.de. 2. Department of Urology, Medical University Center Hamburg-Eppendorf, Hamburg, Germany. 3. Martini-Clinic Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. 4. Department of Urology, Academic Hospital Braunschweig, Salzdahlumerstrasse 90, 38126, Brunswick, Germany. 5. Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Canada. 6. Department of Urology, University of Montreal Health Center, Montreal, Canada.
Abstract
PURPOSE: To verify the reliability of HistoScanning™-based, true targeting (TT)-derived prostate biopsy. METHODS: We relied on 40 patients suspicious for prostate cancer who underwent standard and TT-derived prostate biopsy. Sensitivity, specificity, positive predictive value, negative predictive value and the area under the curve (AUC) were assessed for the prediction of biopsy results per octant by HistoScanning™, using different HistoScanning™ signal volume cutoffs (>0, >0.2 and >0.5 ml). RESULTS: Overall, 319 octants were analyzed. Of those, 64 (20.1 %) harbored prostate cancer. According to different HistoScanning™ signal volume cutoffs (>0, >0.2 and >0.5 ml), the AUCs for predicting biopsy results were: 0.51, 0.51 and 0.53, respectively. Similarly, the sensitivity, specificity, positive predictive and negative predictive values were: 20.7, 78.2, 17.4 and 81.6 %; 20.7, 82.0, 20.3 and 82.3 %; and 12.1, 94.6, 33.3 and 82.9 %, respectively. CONCLUSIONS: Prediction of biopsy results based on HistoScanning™ signals and TT-derived biopsies was unreliable. Moreover, the AUC of TT-derived biopsies was low and did not improve when additional signal volume cutoffs were applied (>0.2 and >0.5 ml). We cannot recommend a variation of well-established biopsy standards or reduction in biopsy cores based on HistoScanning™ signals.
PURPOSE: To verify the reliability of HistoScanning™-based, true targeting (TT)-derived prostate biopsy. METHODS: We relied on 40 patients suspicious for prostate cancer who underwent standard and TT-derived prostate biopsy. Sensitivity, specificity, positive predictive value, negative predictive value and the area under the curve (AUC) were assessed for the prediction of biopsy results per octant by HistoScanning™, using different HistoScanning™ signal volume cutoffs (>0, >0.2 and >0.5 ml). RESULTS: Overall, 319 octants were analyzed. Of those, 64 (20.1 %) harbored prostate cancer. According to different HistoScanning™ signal volume cutoffs (>0, >0.2 and >0.5 ml), the AUCs for predicting biopsy results were: 0.51, 0.51 and 0.53, respectively. Similarly, the sensitivity, specificity, positive predictive and negative predictive values were: 20.7, 78.2, 17.4 and 81.6 %; 20.7, 82.0, 20.3 and 82.3 %; and 12.1, 94.6, 33.3 and 82.9 %, respectively. CONCLUSIONS: Prediction of biopsy results based on HistoScanning™ signals and TT-derived biopsies was unreliable. Moreover, the AUC of TT-derived biopsies was low and did not improve when additional signal volume cutoffs were applied (>0.2 and >0.5 ml). We cannot recommend a variation of well-established biopsy standards or reduction in biopsy cores based on HistoScanning™ signals.
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