Diagnostic accuracy of transperineal MRI fusion biopsy in comparison to transrectal biopsy with regard to incidental histopathological findings in transurethral resection of the prostate
<b><i>Objective:</i></b> To investigate the diagnostic accuracy of transperineal MRI/transrectal ultrasound (TRUS) fusion prostate biopsy vs. transrectal prostate biopsy in transurethral resection (TUR) specimen of men undergoing TUR of the prostate (TURP) for symptomatic bla...
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| Main Authors: | , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
September 2017
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| In: |
Urologia internationalis
Year: 2017, Volume: 99, Issue: 2, Pages: 162-167 |
| ISSN: | 1423-0399 |
| DOI: | 10.1159/000456078 |
| Online Access: | Verlag, Volltext: http://dx.doi.org/10.1159/000456078 Verlag, Volltext: https://www.karger.com/Article/FullText/456078 
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| Author Notes: | Svenja Christina Dieffenbacher, Ionel Valentin Popeneciu, Jan Philipp Radtke, Dogu Teber, Markus Hohenfellner, Boris Alexander Hadaschik, Gencay Hatiboglu |
| Summary: | <b><i>Objective:</i></b> To investigate the diagnostic accuracy of transperineal MRI/transrectal ultrasound (TRUS) fusion prostate biopsy vs. transrectal prostate biopsy in transurethral resection (TUR) specimen of men undergoing TUR of the prostate (TURP) for symptomatic bladder outlet obstruction. <b><i>Material and Methods:</i></b> From a database of 3,509 men receiving prostate biopsy, all those undergoing TURP and negative prostate biopsy (<i>n</i> = 95; 45 transrectal, 50 transperineal fusion) were analysed. TURP specimens were compared with regard to incidental prostate cancer. <b><i>Results:</i></b> Pre- and peri-interventional parameters in transrectal vs. fusion biopsy groups for age (65.2 ± 7.8 vs. 65.5 ± 7.3 years; <i>p</i> = 0.84), prostate specific antigen (10.7 ± 8.5 vs. 10.9 ± 8.7 ng/mL; <i>p</i> = 0.93), preoperative prostate volume (72.5 ± 26.1 vs. 71.8 ± 28.1 mL; <i>p</i> = 0.91) and resected weight (43.7 ± 21.9 vs. 41.4 ± 20.7 g; <i>p</i> = 0.61) showed no significant differences. Analysing the TURP specimen, 5 incidental T1a prostate cancers were found (3 Gleason 3 + 3 = 6; 2 Gleason 3 + 4 = 7, all in the transrectal biopsy group). Although, more biopsy cores were obtained in the MRI/TRUS fusion biopsy group (26 cores [interquartile range, IQR 24-28] vs. 14 cores [IQR 12-24], <i>p</i> < 0.01), there was no statistical impact of the obtained number of cores (<i>p</i> = 0.9) on diagnostic accuracy. Statistical analyses revealed significantly better diagnostic accuracy favoring image-guided fusion biopsy (<i>p</i> = 0.02). <b><i>Conclusions:</i></b> Our findings showed that a combination of MRI-targeted and systematic transperineal prostate biopsy improves patient safety. This is associated with a combination of transperineal biopsy technique and pre-interventional MRI. |
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| Item Description: | Gesehen am 12.11.2018 |
| Physical Description: | Online Resource |
| ISSN: | 1423-0399 |
| DOI: | 10.1159/000456078 |