Comparing 12-core and 20-core Biopsy for Prostate Cancer Diagnosis with Transperineal MR/US Fusion Biopsy: Assessing the Effective Number of Systemic Cores Using Propensity Score Matching

Overview

Journal Int Urol Nephrol

Publisher Springer

Specialty Nephrology

Date 2023 Jun 20

PMID 37340208

Authors

Hyeok Jae Kwon

Seung Ah Rhew

Chang Eil Yoon

Dongho Shin

Seokhwan Bang

Yong Hyun Park

Hyuk Jin Cho

U-Syn Ha

Sung-Hoo Hong

Ji Youl Lee

Sae Woong Kim

Hyong Woo Moon

Affiliations

Soon will be listed here.

Abstract

Purpose: For transperineal (TP) prostate biopsy, target biopsy for visible lesions on MRI is important, but there is no consensus of the number of systemic biopsy cores. Our study aimed to confirm the diagnostic efficiency of 20-core systemic biopsy by comparison with 12-core using propensity score matching (PSM).

Methods: The 494 patients conducted the naive TP biopsy were retrospectively analyzed. There were 293 patients with 12-core biopsy and 201 patients with 20-core biopsy. PSM was performed for minimizing confounding variables, and the established effects' value was analyzed for 'index-positive or negative' clinically significant prostate cancer (csPCa) (Index means PIRADS Score ≥ 3 on multiparametric prostate MRI).

Results: At 12-core biopsy, there were 126 cases of prostate cancer (43.0%), and 97 cases of csPCa (33.1%). At 20-core biopsy, there were 91 cases (45.3%) and 63 cases (31.3%). After propensity score matching, for index-negative csPCa, the estimated odds ratio was 4.03 (95% CI 1.35-12.09, p value 0.0128), and for index-positive csPCa, the estimated odds ratio was 0.98 (95% CI 0.63-1.52, p value 0.9308).

Conclusions: The 20-core biopsy did not show a higher detection rate for csPCa in comparison with the 12-core biopsy. However, when MRI did not show a suspicious lesion, 20-core biopsy showed higher odd ratio in comparison with 12-core biopsy. Therefore, if there is a suspicious lesion in MRI, 20-core biopsy is excessive and 12-core biopsy is sufficient. Whereas if there is no suspicious lesion in MRI, it is better to proceed with 20-core biopsy.

Citing Articles

Role of Systematic Biopsy in the Era of Targeted Biopsy: A Review.

Malewski W, Milecki T, Tayara O, Poletajew S, Kryst P, Tokarczyk A Curr Oncol. 2024; 31(9):5171-5194.

PMID: 39330011 PMC: 11430858. DOI: 10.3390/curroncol31090383.

References

Sung H, Ferlay J, Siegel R, Laversanne M, Soerjomataram I, Jemal A . Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021; 71(3):209-249. DOI: 10.3322/caac.21660. View

Jung K, Won Y, Hong S, Kong H, Im J, Seo H . Prediction of Cancer Incidence and Mortality in Korea, 2021. Cancer Res Treat. 2021; 53(2):316-322. PMC: 8053854. DOI: 10.4143/crt.2021.290. View

Bjurlin M, Carter H, Schellhammer P, Cookson M, Gomella L, Troyer D . Optimization of initial prostate biopsy in clinical practice: sampling, labeling and specimen processing. J Urol. 2013; 189(6):2039-46. PMC: 3925148. DOI: 10.1016/j.juro.2013.02.072. View

Serefoglu E, Altinova S, Ugras N, Akincioglu E, Asil E, Balbay M . How reliable is 12-core prostate biopsy procedure in the detection of prostate cancer?. Can Urol Assoc J. 2012; 7(5-6):E293-8. PMC: 3668408. DOI: 10.5489/cuaj.11224. View

Chiang I, Chang S, Pu Y, Huang K, Yu H, Huang C . Major complications and associated risk factors of transrectal ultrasound guided prostate needle biopsy: a retrospective study of 1875 cases in taiwan. J Formos Med Assoc. 2007; 106(11):929-34. DOI: 10.1016/S0929-6646(08)60063-7. View

Liss M, Ehdaie B, Loeb S, Meng M, Raman J, Spears V . An Update of the American Urological Association White Paper on the Prevention and Treatment of the More Common Complications Related to Prostate Biopsy. J Urol. 2017; 198(2):329-334. DOI: 10.1016/j.juro.2017.01.103. View

Kasivisvanathan V, Rannikko A, Borghi M, Panebianco V, Mynderse L, Vaarala M . MRI-Targeted or Standard Biopsy for Prostate-Cancer Diagnosis. N Engl J Med. 2018; 378(19):1767-1777. PMC: 9084630. DOI: 10.1056/NEJMoa1801993. View

Scheenen T, Rosenkrantz A, Haider M, Futterer J . Multiparametric Magnetic Resonance Imaging in Prostate Cancer Management: Current Status and Future Perspectives. Invest Radiol. 2015; 50(9):594-600. DOI: 10.1097/RLI.0000000000000163. View

Moore C, Robertson N, Arsanious N, Middleton T, Villers A, Klotz L . Image-guided prostate biopsy using magnetic resonance imaging-derived targets: a systematic review. Eur Urol. 2012; 63(1):125-40. DOI: 10.1016/j.eururo.2012.06.004. View

10.

Bjurlin M, Taneja S . Standards for prostate biopsy. Curr Opin Urol. 2014; 24(2):155-61. PMC: 4142196. DOI: 10.1097/MOU.0000000000000031. View

11.

Drost F, Osses D, Nieboer D, Bangma C, Steyerberg E, Roobol M . Prostate Magnetic Resonance Imaging, with or Without Magnetic Resonance Imaging-targeted Biopsy, and Systematic Biopsy for Detecting Prostate Cancer: A Cochrane Systematic Review and Meta-analysis. Eur Urol. 2019; 77(1):78-94. DOI: 10.1016/j.eururo.2019.06.023. View

12.

van der Leest M, Cornel E, Israel B, Hendriks R, Padhani A, Hoogenboom M . Head-to-head Comparison of Transrectal Ultrasound-guided Prostate Biopsy Versus Multiparametric Prostate Resonance Imaging with Subsequent Magnetic Resonance-guided Biopsy in Biopsy-naïve Men with Elevated Prostate-specific Antigen: A Large.... Eur Urol. 2018; 75(4):570-578. DOI: 10.1016/j.eururo.2018.11.023. View

13.

Artiles Medina A, Rodriguez-Patron Rodriguez R, Ruiz Hernandez M, Mata Alcaraz M, Garcia Barreras S, Fernandez Conejo G . Identifying Risk Factors for MRI-Invisible Prostate Cancer in Patients Undergoing Transperineal Saturation Biopsy. Res Rep Urol. 2021; 13:723-731. PMC: 8486270. DOI: 10.2147/RRU.S323823. View

14.

Kuhlmann P, Chen M, Luu M, Naser-Tavakolian A, Patel D, Kim H . Patient- and tumor-level risk factors for MRI-invisible prostate cancer. Prostate Cancer Prostatic Dis. 2021; 24(3):794-801. DOI: 10.1038/s41391-021-00330-7. View

15.

Meng M, Elkin E, DuChane J, Carroll P . Impact of increased number of biopsies on the nature of prostate cancer identified. J Urol. 2006; 176(1):63-8. DOI: 10.1016/S0022-5347(06)00493-9. View

16.

Bezinque A, Moriarity A, Farrell C, Peabody H, Noyes S, Lane B . Determination of Prostate Volume: A Comparison of Contemporary Methods. Acad Radiol. 2018; 25(12):1582-1587. DOI: 10.1016/j.acra.2018.03.014. View

17.

Bangma C, Niemer A, Grobbee D, Schroder F . Transrectal ultrasonic volumetry of the prostate: in vivo comparison of different methods. Prostate. 1996; 28(2):107-10. DOI: 10.1002/(SICI)1097-0045(199602)28:2<107::AID-PROS5>3.0.CO;2-D. View

18.

Shoji S, Hiraiwa S, Uemura K, Nitta M, Hasegawa M, Kawamura Y . Focal therapy with high-intensity focused ultrasound for the localized prostate cancer for Asian based on the localization with MRI-TRUS fusion image-guided transperineal biopsy and 12-cores transperineal systematic biopsy: prospective analysis of.... Int J Clin Oncol. 2020; 25(10):1844-1853. DOI: 10.1007/s10147-020-01723-9. View

19.

Valerio M, Anele C, Charman S, van der Meulen J, Freeman A, Jameson C . Transperineal template prostate-mapping biopsies: an evaluation of different protocols in the detection of clinically significant prostate cancer. BJU Int. 2015; 118(3):384-90. DOI: 10.1111/bju.13306. View

20.

Pepe P, Aragona F . Morbidity after transperineal prostate biopsy in 3000 patients undergoing 12 vs 18 vs more than 24 needle cores. Urology. 2013; 81(6):1142-6. DOI: 10.1016/j.urology.2013.02.019. View