Software-assisted US/MRI fusion-targeted biopsy for prostate cancer

Main Article Content

Salvatore Alessio Angileri
Letizia Di Meglio
Mario Petrillo
Antonio Arrichiello
Marco Pandolfi
Giovanni Maria Rodà
Giuseppe Granata
Anna Maria Ierardi
Daniela Donat
Aldo Paolucci
Gianpaolo Carrafiello

Keywords

Prostate Biopsy, Prostate Cancer, TRUS, Fusion Biopsy

Abstract

Background: Prostate cancer is the first cancer diagnosis in men. European Association of Urology  (EAU) Guidelines for Prostate Cancer underline the importance of screening, performed through PSA testing on all men with more than 50 years of age and before on men with risk factors. The diagnosis is still histopathologic, and it is done on the basis of the findings on biopsy samples. Materials and Methods: Fusion biopsy is a relatively new technique that allows the operator to perform the biopsies in office instead of the MRI gantry, without losing the detection capability of MRI. The  T2-wighted images obtained during a previous mpMRI are merged with the real-time ones of the TRUS. Results: Fusion biopsy in comparison with the systematic standard biopsy has a better detection rate of clinically significant cancers and of any cancers. Conclusion: EAU 2020 guidelines still do offer a list of indications of when the biopsy should be performed, but it still appeared to be overperformed. The aim of our study is to underline how, in accordance with the recent literature result,  fusion biopsy has showed a better detection rate of any cancer and clinically significant disease with a reduced numbers of samplings, and no substantial difference between the multiple software. 

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References

1. Siegel, R. L., Miller, K. D. & Jemal, A. Cancer statistics, 2019. CA. Cancer J. Clin. 69, 7–34 (2019).
2. Verma, S. et al. The current state of MR imaging-targeted biopsy techniques for detection of prostate cancer. Radiology vol. 285 343–356 (2017).
3. Djavan, B. & Margreiter, M. Biopsy standards for detection of prostate cancer. World J. Urol. 25, 11–17 (2007).
4. Roobol, M. J. et al. A Risk-Based Strategy Improves Prostate-Specific Antigen-Driven Detection of Prostate Cancer. Eur. Urol. 57, 79–85 (2010).
5. EAU. EAU 2020 Guidelines for Prostate Cancer. https://uroweb.org/guideline/prostate-cancer/ (2020).
6. Pesapane, F. et al. The prostate cancer focal therapy. Gland Surgery vol. 7 89–102 (2018).
7. PI-RADS ® v2.1 PI-RADS ® Prostate Imaging-Reporting and Data System 2019 Version 2.1 PI-RADS ® Prostate Imaging-Reporting and Data System 2019 Version 2.1.
8. Streicher, J., Meyerson, B. L., Karivedu, V. & Sidana, A. A review of optimal prostate biopsy: indications and techniques. Ther. Adv. Urol. 11, 175628721987007 (2019).
9. Eichler, K. et al. Diagnostic Value of Systematic Biopsy Methods in the Investigation of Prostate Cancer: A Systematic Review. J. Urol. 175, 1605–1612 (2006).
10. Shariat, S. F. & Roehrborn, C. G. Using biopsy to detect prostate cancer. Rev. Urol. 10, 262–80 (2008).
11. Pesapane, F. et al. Intravoxel Incoherent Motion (IVIM) Diffusion Weighted Imaging (DWI) in the Periferic Prostate Cancer Detection and Stratification. Med. Oncol. 34, 1–9 (2017).
12. Guo, L. H. et al. Comparison between Ultrasound Guided Transperineal and Transrectal Prostate Biopsy: A Prospective, Randomized, and Controlled Trial. Sci. Rep. 5, 1–10 (2015).
13. Bastian-Jordan, M. Magnetic resonance imaging of the prostate and targeted biopsy, Comparison of PIRADS and Gleason grading. J. Med. Imaging Radiat. Oncol. 62, 183–187 (2018).
14. Michael Kongnyuy, M.S, Arvin K. George, M.D, Ardeshir R. Rastinehad, D.O, and Peter A. Pinto, M. . Magnetic Resonance Imaging-Ultrasound Fusion-Guided Prostate Biopsy: Review of Technology, Techniques, and Outcomes. Curr. Urol. Rep. 176, 139–148 (2017).
15. Schütz, V. et al. Multiparametric MRI and MRI/TRUS Fusion Guided Biopsy for the Diagnosis of Prostate Cancer. Adv. Exp. Med. Biol. 1096, 87–98 (2018).
16. Borkowetz, A. et al. Comparison of systematic transrectal biopsy to transperineal magnetic resonance imaging/ultrasound-fusion biopsy for the diagnosis of prostate cancer. BJU Int. 116, 873–879 (2015).
17. Borghesi, M. et al. Complications After Systematic, Random, and Image-guided Prostate Biopsy [figure presented]. European Urology vol. 71 353–365 (2017).
18. Martorana, E. et al. Prostate MRI and transperineal TRUS/MRI fusion biopsy for prostate cancer detection: Clinical practice updates. Turkish J. Urol. 45, 237–244 (2019).
19. Ierardi, A. M. et al. Bleeding after prostatectomy: Endovascular management. Gland Surg. 8, 108–114 (2019).
20. Martorana, E. et al. Lesion volume predicts prostate cancer risk and aggressiveness: validation of its value alone and matched with prostate imaging reporting and data system score. BJU Int. 120, 92–103 (2017).
21. Valerio, M. et al. Detection of clinically significant prostate cancer using magnetic resonance imaging-ultrasound fusion targeted biopsy: A systematic review. Eur. Urol. 68, 8–19 (2015).
22. Loeb, S. et al. Systematic review of complications of prostate biopsy. Eur. Urol. 64, 876–892 (2013).