Reducing the number of systematic biopsy cores in the era of MRI targeted biopsy—implications on clinically-significant prostate cancer detection and relevance to focal therapy planning

By Lee AYM, Chen K, Tan YG, et al
Published January 14, 2022

Key Takeaways

When conducting an MRI-targeted biopsy, decreasing the number of systematic biopsies not only resulted in decreased detection of clinically-significant prostate cancer (csPCa defined as grade group ≥2) but also modified the treatment plans for focal therapy, probably limiting its oncological efficacy.

  • This retrospective study of 398 consecutive men who had both systematic saturation (~24 cores) and MRI-US fusion targeted biopsy was conducted to determine the effect of decreasing the number of systematic cores on prostate cancer detection in the era of MRI-US fusion targeted biopsy and as well as its relevance in template planning for focal therapy.

  • The presence of csPCa was evident in 42% (168/398) of participants.

  • The csPCa detection rate was 21% (83/398) with non-targeted systematic saturation biopsy.

  • Four reduced-core systematic biopsy strategies (two-thirds, half, one-third and one-quarter systematic cores) decreased the mean number of non-targeted systematic cores from 21.8 to 14.5, 10.9, 7.3 and 5.4 cores and their csPCa detection rates were significantly reduced to 16%, 13%, 9% and 8% respectively.

  • A full systematic saturation biopsy vs the reduced-core strategies led to change to the focal therapy treatment plan in 12% (2/3 cores), 19% (1/2 cores), 24% (1/3 cores) and 29% (1/4 cores) of the time.

Read the full article on Prostate Cancer & Prostatic Diseases.

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