Xiaosong Meng1, Andrew B Rosenkrantz2, Richard Huang1, Fang-Ming Deng3, James S Wysock1, Marc A Bjurlin4, William C Huang1, Herbert Lepor1, Samir S Taneja5. 1. Department of Urology, New York University Langone Health, New York, New York. 2. Department of Radiology, New York University Langone Health, New York, New York. 3. Department of Pathology, New York University Langone Health, New York, New York. 4. Department of Urology, New York University Langone Hospital-Brooklyn, Brooklyn, New York. 5. Department of Urology, New York University Langone Health, New York, New York; Department of Radiology, New York University Langone Health, New York, New York. Electronic address: Samir.Taneja@nyumc.org.
Abstract
PURPOSE: While magnetic resonance imaging-ultrasound fusion targeted biopsy allows for improved detection of clinically significant prostate cancer, a concerning amount of clinically significant disease is still missed. We hypothesized that a number of these misses are due to the learning curve associated with magnetic resonance imaging-ultrasound fusion targeted biopsy. We report the results of repeat magnetic resonance imaging-ultrasound fusion targeted biopsy in men with continued suspicion for cancer and the institutional learning curve in the detection of clinically significant prostate cancer with time. MATERIALS AND METHODS: We analyzed the records of 1,813 prostate biopsies in a prospectively acquired cohort of men who presented for prostate biopsy in a 4-year period. All men were offered prebiopsy magnetic resonance imaging and were assigned a maximum PI-RADS™ (Prostate Imaging Reporting and Data System version 2) score. Biopsy outcomes in men with a suspicious region of interest were compared. The relationship between time and clinically significant prostate cancer detection was analyzed. RESULTS: The clinically significant prostate cancer detection rate increased 26% with time in men with a PI-RADS 4/5 region of interest. On repeat magnetic resonance imaging-ultrasound fusion targeted biopsy in men with continued suspicion for cancer 53% of those with a PI-RADS 4/5 region of interest demonstrated clinically significant discordance from the initial magnetic resonance imaging-ultrasound fusion targeted biopsy compared to only 23% with a PI-RADS 1/2 region of interest. Significantly less clinically significant prostate cancer was missed or under graded in the most recent biopsies compared to the earliest biopsies. CONCLUSIONS: The high upgrade rate on repeat magnetic resonance imaging-ultrasound fusion targeted biopsy and the increasing cancer detection rate with time show the significant learning curve associated with magnetic resonance imaging-ultrasound fusion targeted biopsy. Men with low risk or negative biopsies with a persistent, concerning region of interest should be promptly rebiopsied. Improved targeting accuracy with operator experience can help decrease the number of missed cases of clinically significant prostate cancer.
PURPOSE: While magnetic resonance imaging-ultrasound fusion targeted biopsy allows for improved detection of clinically significant prostate cancer, a concerning amount of clinically significant disease is still missed. We hypothesized that a number of these misses are due to the learning curve associated with magnetic resonance imaging-ultrasound fusion targeted biopsy. We report the results of repeat magnetic resonance imaging-ultrasound fusion targeted biopsy in men with continued suspicion for cancer and the institutional learning curve in the detection of clinically significant prostate cancer with time. MATERIALS AND METHODS: We analyzed the records of 1,813 prostate biopsies in a prospectively acquired cohort of men who presented for prostate biopsy in a 4-year period. All men were offered prebiopsy magnetic resonance imaging and were assigned a maximum PI-RADS™ (Prostate Imaging Reporting and Data System version 2) score. Biopsy outcomes in men with a suspicious region of interest were compared. The relationship between time and clinically significant prostate cancer detection was analyzed. RESULTS: The clinically significant prostate cancer detection rate increased 26% with time in men with a PI-RADS 4/5 region of interest. On repeat magnetic resonance imaging-ultrasound fusion targeted biopsy in men with continued suspicion for cancer 53% of those with a PI-RADS 4/5 region of interest demonstrated clinically significant discordance from the initial magnetic resonance imaging-ultrasound fusion targeted biopsy compared to only 23% with a PI-RADS 1/2 region of interest. Significantly less clinically significant prostate cancer was missed or under graded in the most recent biopsies compared to the earliest biopsies. CONCLUSIONS: The high upgrade rate on repeat magnetic resonance imaging-ultrasound fusion targeted biopsy and the increasing cancer detection rate with time show the significant learning curve associated with magnetic resonance imaging-ultrasound fusion targeted biopsy. Men with low risk or negative biopsies with a persistent, concerning region of interest should be promptly rebiopsied. Improved targeting accuracy with operator experience can help decrease the number of missed cases of clinically significant prostate cancer.
Authors: Marc A Bjurlin; Peter R Carroll; Scott Eggener; Pat F Fulgham; Daniel J Margolis; Peter A Pinto; Andrew B Rosenkrantz; Jonathan N Rubenstein; Daniel B Rukstalis; Samir S Taneja; Baris Turkbey Journal: J Urol Date: 2019-10-23 Impact factor: 7.450
Authors: Annerleim Walton-Diaz; Manuel Madariaga-Venegas; Nicolas Aviles; Juan Carlos Roman; Ivan Gallegos; Mauricio Burotto Journal: Curr Urol Rep Date: 2019-09-02 Impact factor: 3.092
Authors: Emanuel Darius Cata; Iulia Andras; Teodora Telecan; Attila Tamas-Szora; Radu-Tudor Coman; Dan-Vasile Stanca; Ioan Coman; Nicolae Crisan Journal: Med Pharm Rep Date: 2021-04-29
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
Authors: Armando Stabile; Francesco Giganti; Veeru Kasivisvanathan; Gianluca Giannarini; Caroline M Moore; Anwar R Padhani; Valeria Panebianco; Andrew B Rosenkrantz; Georg Salomon; Baris Turkbey; Geert Villeirs; Jelle O Barentsz Journal: Eur Urol Oncol Date: 2020-03-17
Authors: Michael Ahdoot; Andrew R Wilbur; Sarah E Reese; Amir H Lebastchi; Sherif Mehralivand; Patrick T Gomella; Jonathan Bloom; Sandeep Gurram; Minhaj Siddiqui; Paul Pinsky; Howard Parnes; W Marston Linehan; Maria Merino; Peter L Choyke; Joanna H Shih; Baris Turkbey; Bradford J Wood; Peter A Pinto Journal: N Engl J Med Date: 2020-03-05 Impact factor: 91.245
Authors: Keiran D Clement; Lizzy Day; Helen Rooney; Matt Neilson; Fiona Birrell; Mark Salji; Elizabeth Norman; Ross Clark; Amit Patel; John Morrison; Hing Y Leung Journal: Asian J Androl Date: 2021 May-Jun Impact factor: 3.285