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Prostate cancer detection in patients with prior negative biopsy undergoing cognitive-, robotic- or in-bore MRI target biopsy

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Abstract

Purpose

To evaluate the detection rate among three different targeted biopsy approaches of robot-assisted MRI/TRUS fusion (RA-TB), mpMRI in-bore (MRGB), cognitive fusion guidance biopsy (COG-TB) for the detection of prostate cancer (PC) and clinically significant PC (csPC).

Methods

Between 2014 and 2016, 156 patients with a lesion on mpMRI, performed in accordance with ESUR guidelines, due to cancer suspicion or on-going cancer suspicion after prior negative prostate biopsy, underwent targeted biopsy with RA-TB, MRGB or COG-TB. All lesions were rated according to PI-RADS v2. We compared detection rates between techniques. Models were constructed to predict the detection of overall PC and csPC and using a 1000 boot-strap sample.

Results

In the all cohort, 73, 45 and 38 patients underwent RA-TB, MRGB or COG-TB, respectively. Overall PC was found in 39 (52.42%), 23 (51.11%) and 11 (28.95%) (p = 0.04) patients of RA-TB, MRGB and COG-TB arm, respectively. As concerning the detection of csPC, it was found in 26 (35.62%),18 (40.0%) and 9 (23.68%) patients of RA-TB, MRGB and COG-TB arm (p = 0.27). Model 1 showed that RA-TB [OR: 10.08 (95% CI 1.95–51.97); p < 0.01] and MRGB [OR: 12.88 (95% CI 2.36–70.25); p < 0.01] were associated with overall PC detection in TB, while only MRGB was associated with csPC at TB (model 2) [OR: 5.72; (95% CI 1.40–23.35); p < 0.01]. The c-index for model 1 and model 2 was 0.86 and 0.85, respectively. We did not report significant complications between groups.

Conclusion

In-bore biopsy and MRI/TRUS fusion-guided biopsy showed greater accuracy in detecting PC compared to cognitive fusion as modeled in a newly established normogram.

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Acknowledgements

We thank Johannes Mischinger for helpful discussion of the manuscript.

Funding

No funding was received for this work. Stephan Kruck received travel Grant from Biobot Surgical Company.

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Authors and Affiliations

  1. Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Hoppe-Seyler-Str.3, 72076, Tübingen, Germany

    Sascha Kaufmann, Fabian Bamberg & Konstantin Nikolaou

  2. Department of Urology, Eberhard-Karls-University, Hoppe-Seyler-Str.3, 72076, Tübingen, Germany

    Sascha Kaufmann, Giorgio I. Russo, Lorenz Löwe, Arnulf Stenzl, Stephan Kruck & Jens Bedke

  3. Urology Section, Department of Surgery, University of Catania, Via Santa Sofia 78, 95125, Catania, Italy

    Giorgio I. Russo & Giuseppe Morgia

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  1. Sascha Kaufmann
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Contributions

SK protocol/project development, data collection, manuscript writing. GIR manuscript writing, data analysis. FB protocol/project development. LL protocol/project development. GM protocol/project development. KN protocol/project development. AS protocol/project development. SK protocol/project development, data collection, manuscript writing. JB protocol/project development, manuscript writing.

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Correspondence to Giorgio I. Russo or Stephan Kruck.

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Research involving human participants and/or animals

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The local ethic committee approved the study (397/2012R).

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Informed consent was obtained from all individual participants included in the study.

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Kaufmann, S., Russo, G.I., Bamberg, F. et al. Prostate cancer detection in patients with prior negative biopsy undergoing cognitive-, robotic- or in-bore MRI target biopsy. World J Urol 36, 761–768 (2018). https://doi.org/10.1007/s00345-018-2189-7

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  • DOI: https://doi.org/10.1007/s00345-018-2189-7

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