AIM: To evaluate the accuracy of multiparametric magnetic resonance-transrectal ultrasound fusion targeted biopsy (TBx) in the characterization of the index tumor, as confirmed by association with radical prostatectomy (RP) specimens. PATIENTS AND METHODS: A total of 152 patients with TBx-confirmed prostate cancer (PCa) underwent robot-assisted RP. Stained whole-mount histological sections were used as the reference standard. All lesions with a volume >0.5 ml and/or pathological Gleason score (GS) >6 were defined as clinically significant PCa. The index lesion was defined as the largest tumor focus within the prostate gland. RESULTS: The pathological index tumours included: 147 lesions (96.7%) with a volume >0.5 ml and five (3.3%) with a volume ≤0.5 ml, but with a pathological GS ≥7; 135 (88.8%) were located in the peripheral zone. TBx accuracy in the detection of the correct site of the index lesion by reference standard was 82.2%. Sensitivity, specificity, positive and negative predictive value were: 82.3%, 50.4%, 82.8% and 49.7%, respectively. The primary/secondary Gleason grade and GS of the 152 index tumors were properly estimated in 130 (85.5%), 115 (75.6%) and 127 (83.6%) cases, respectively. The concordance of TBx with pathological GS was 83.6%. The rate of up-grading and down-grading of TBx Gleason sum was 12.2% and 4.2%, respectively. CONCLUSION: TBx has a high sensitivity for characterization of index lesions, with a good concordance for topographic and Gleason grading accuracy between biopsy and surgical specimens. Copyright
AIM: To evaluate the accuracy of multiparametric magnetic resonance-transrectal ultrasound fusion targeted biopsy (TBx) in the characterization of the index tumor, as confirmed by association with radical prostatectomy (RP) specimens. PATIENTS AND METHODS: A total of 152 patients with TBx-confirmed prostate cancer (PCa) underwent robot-assisted RP. Stained whole-mount histological sections were used as the reference standard. All lesions with a volume >0.5 ml and/or pathological Gleason score (GS) >6 were defined as clinically significant PCa. The index lesion was defined as the largest tumor focus within the prostate gland. RESULTS: The pathological index tumours included: 147 lesions (96.7%) with a volume >0.5 ml and five (3.3%) with a volume ≤0.5 ml, but with a pathological GS ≥7; 135 (88.8%) were located in the peripheral zone. TBx accuracy in the detection of the correct site of the index lesion by reference standard was 82.2%. Sensitivity, specificity, positive and negative predictive value were: 82.3%, 50.4%, 82.8% and 49.7%, respectively. The primary/secondary Gleason grade and GS of the 152 index tumors were properly estimated in 130 (85.5%), 115 (75.6%) and 127 (83.6%) cases, respectively. The concordance of TBx with pathological GS was 83.6%. The rate of up-grading and down-grading of TBx Gleason sum was 12.2% and 4.2%, respectively. CONCLUSION:TBx has a high sensitivity for characterization of index lesions, with a good concordance for topographic and Gleason grading accuracy between biopsy and surgical specimens. Copyright
Authors: Antonio C Westphalen; Charles E McCulloch; Jordan M Anaokar; Sandeep Arora; Nimrod S Barashi; Jelle O Barentsz; Tharakeswara K Bathala; Leonardo K Bittencourt; Michael T Booker; Vaughn G Braxton; Peter R Carroll; David D Casalino; Silvia D Chang; Fergus V Coakley; Ravjot Dhatt; Steven C Eberhardt; Bryan R Foster; Adam T Froemming; Jurgen J Fütterer; Dhakshina M Ganeshan; Mark R Gertner; Lori Mankowski Gettle; Sangeet Ghai; Rajan T Gupta; Michael E Hahn; Roozbeh Houshyar; Candice Kim; Chan Kyo Kim; Chandana Lall; Daniel J A Margolis; Stephen E McRae; Aytekin Oto; Rosaleen B Parsons; Nayana U Patel; Peter A Pinto; Thomas J Polascik; Benjamin Spilseth; Juliana B Starcevich; Varaha S Tammisetti; Samir S Taneja; Baris Turkbey; Sadhna Verma; John F Ward; Christopher A Warlick; Andrew R Weinberger; Jinxing Yu; Ronald J Zagoria; Andrew B Rosenkrantz Journal: Radiology Date: 2020-04-21 Impact factor: 11.105