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A prospective study on inter-operator variability in semi-robotic software-based MRI/TRUS-fusion targeted prostate biopsies

Purpose  Magnetic resonance imaging (MRI)/ultrasound-fusion prostate biopsy (FB) comprises multiple steps each of which can cause alterations in targeted biopsy (TB) accuracy leading to false-negative results. The aim was to assess the interoperator variability of software-based fusion TB by targeti...

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Main Authors: Derigs, Fabian (Author) , Doryumu, Samuel (Author) , Tollens, Fabian (Author) , Nörenberg, Dominik (Author) , Neuberger, Manuel (Author) , Hardenberg, Jost von (Author) , Michel, Maurice Stephan (Author) , Ritter, Manuel (Author) , Westhoff, Niklas Christian (Author)
Format: Article (Journal)
Language:English
Published: 2022
In: World journal of urology
Year: 2022, Volume: 40, Issue: 2, Pages: 427-433
ISSN:1433-8726
DOI:10.1007/s00345-021-03891-3
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.1007/s00345-021-03891-3
Verlag, kostenfrei, Volltext: https://link.springer.com/10.1007/s00345-021-03891-3
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Author Notes:Fabian Derigs, Samuel Doryumu, Fabian Tollens, Dominik Nörenberg, Manuel Neuberger, Jost Von Hardenberg, Maurice Stephan Michel, Manuel Ritter, Niklas Westhoff
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Summary:Purpose  Magnetic resonance imaging (MRI)/ultrasound-fusion prostate biopsy (FB) comprises multiple steps each of which can cause alterations in targeted biopsy (TB) accuracy leading to false-negative results. The aim was to assess the interoperator variability of software-based fusion TB by targeting the same MRI-lesions by different urologists. - Methods  In this prospective study, 142 patients eligible for analysis underwent software-based FB. TB of all lesions (n = 172) were carried out by two different urologists per patient (n = 31 urologists). We analyzed the number of mismatches [overall prostate cancer (PCa), clinically significant PCa (csPCa) and non-significant PCa (nsPCa)] between both performed TB per patient. In addition we evaluated factors contributing to inter-operator variability by uni- and multivariable analyses. - Results  In 11.6% of all MRI-lesions (10.6% of all patients) there was a mismatch between TB1 and TB2 in terms of overall prostate cancer (PCa detection. Regarding csPCa, patient-based mismatch occurred in 14.8% (n = 21). Overall PCa and csPCa detection rate of TB1 and TB2 did not differ significantly on a per-patient and per-lesion level. Analyses revealed a smaller lesion size as predictive for mismatches (OR 9.19, 95% CI 2.02-41.83, p < 0.001). - Conclusion  Reproducibility and precision of targeting particularly small lesions is still limited although using software-based FB. Further improvements in image-fusion, segmentation, needle-guidance, and automatization are necessary.
Item Description:Published online: 26 November 2021
Gesehen am 07.06.2023
Physical Description:Online Resource
ISSN:1433-8726
DOI:10.1007/s00345-021-03891-3

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