Cognitive magnetic resonance imaging-ultrasound fusion transperineal targeted biopsy combined with randomized biopsy in detection of prostate cancer

BACKGROUND Prostate cancer(PCa)is one of the most common cancers among men.Various strategies for targeted biopsy based on multiparametric magnetic resonance imaging(mp-MRI)have emerged,which may improve the accuracy of detecting clinically significant PCa in recent years.AIM To investigate the diagnostic efficiency of a template for cognitive MRIultrasound fusion transperineal targeted plus randomized biopsy in detecting PCa.METHODS Data from patients with an increasing prostate-specific antigen(PSA)level but less than 20 ng/mL and at least one lesion suspicious for PCa on MRI from December 2015 to June 2018 were retrospectively analyzed.All patients underwent cognitive fusion transperineal template-guided targeted biopsy followed by randomized biopsy outside the targeted area.A total of 127 patients with complete data were included in the final analysis.A multivariable logistic regression analysis was conducted,and a two-sided P<0.05 was considered statistically significant.RESULTS PCa was detected in 66 of 127 patients,and 56 cases presented clinically significant PCa.Cognitive fusion targeted biopsy alone detected 59/127 cases of PCa,specifically 52/59 cases with clinically significant PCa and 7/59 cases with clinically insignificant PCa.A randomized biopsy detected seven cases of PCa negative on targeted biopsy,and four cases had clinically significant PCa.PSA density(OR:1.008,95%CI:1.003-1.012,P=0.001;OR:1.006,95%CI:1.002-1.010,P=0.004)and Prostate Imaging-Reporting and Data System(PI-RADS)scores(both P<0.001)were independently associated with the results of cognitive fusion targeted biopsy combined with randomized biopsy and targeted biopsy alone.CONCLUSION This single-centered study proposed a feasible template for cognitive MRIultrasound fusion transperineal targeted plus randomized biopsy.Patients with higher PSAD and PI-RADS scores were more likely to be diagnosed with PCa.

Comparison of Cognitive Registration Transrectal Ultrasound-Guided Targeted Biopsy of Prostate to Systematic 12-Core Biopsy: A Retrospective, Multicentre Study

Introduction: Prostate cancer (PCa) is the third most prevalent cancer among Malaysian males, often diagnosed at advanced stages, leading to suboptimal outcomes. While transrectal ultrasound-guided systematic biopsy (TRUS-SB) is the primary diagnostic method, prebiopsy multiparametric magnetic resonance imaging (mpMRI) is gaining popularity in identifying suspicious lesions. This study addresses the lack of comprehensive investigations into the efficacy of cognitive registration TRUS targeted biopsy (COG-TB) compared to conventional TRUS-SB, considering the resource limitations of the Malaysian healthcare system. Materials and Methods: A retrospective cohort study was conducted in two Malaysian healthcare facilities. 116 adult patients with a prostate-specific antigen (PSA) level of more than 4 ng/mL who underwent both COG-TB and TRUS-SB between October 2020 and March 2022 were included. Primary outcomes were cancer detection rate and histopathological outcomes, including Gleason score. Results: COG-TB showed a higher overall cancer detection rate (50%) compared to TRUS-SB (44%). Clinically significant cancer detection rates were similar between COG-TB and TRUS-SB (37.1%). Further analysis revealed that both COG-TB and TRUS-SB detected clinically significant cancer in 30.2% of patients, did not detect it in 56.0%, and had conflicting findings in 16 patients (p Conclusion: COG-TB and TRUS-SB have comparable detection rates for clinically significant prostate cancer, with COG-TB showing a higher tendency to detect insignificant prostate cancer. Further studies comparing these methods are warranted.

Value of cognitive fusion targeted and standard systematic transrectal prostate biopsy for prostate cancer diagnosis

The aim of this study was to compare the accuracies of cognitive fusion-guided targeted biopsy(TB),systematic biopsy(SB),and combined TB+SB for the detection of prostate cancer(PCa)and clinically significant PCa(csPCa)in males with lesions detected by magnetic resonance imaging(MRI).We conducted a retrospective analysis of individuals who underwent prostate biopsy at Peking University People's Hospital(Beijing,China),with an emphasis on patients with both transrectal TB and SB.The main objective was to determine the precisions of SB,TB,and TB+SB for diagnosing PCa and csPCa.We also evaluated the detection rates of TB,SB,TB+ipsilateral-SB(ipsi-SB),TB+contralateral-SB(contra-SB),and TB+SB for PCa and csPCa in patients with unilateral MRI lesions.We compared the diagnostic yields of the various biopsy schemes using the McNemar’s test.A total of 180 patients were enrolled.The rates of PCa detection using TB,SB,and TB+SB were 52.8%,62.2%,and 66.7%,respectively,and the corresponding rates for csPCa were 46.1%,56.7%,and 58.3%,respectively.Among patients with unilateral MRI lesions,the PCa detection rates for TB,SB,TB+ipsi-SB,TB+contra-SB,and TB+SB were 53.3%,64.8%,65.6%,61.5%,and 68.0%,respectively.TB+ipsi-SB detected 96.4%of PCa and 95.9%of csPCa cases.These findings suggest that the combination of TB+SB has better diagnostic accuracy compared with SB or TB alone.For patients with unilateral MRI lesions,the combination of TB+ipsi-SB may be suitable in clinical settings.

Initial experience with a novel method for cognitive transperineal magnetic resonance imaging-targeted prostate biopsy

A cognitive magnetic resonance imaging(MRI)-targeted prostate biopsy conducted by an experienced clinician enhances the detection rate of(high-grade)prostate cancer;however,this method is less successful in the hands of inexperienced surgeons.Therefore,an alternative method of conducting a cognitive MRI-targeted biopsy that can be successfully performed by the inexperienced clinicians should be developed.Ninety-six males suspected of prostate cancer were analyzed using systematic biopsy and cognitive MRI-targeted biopsy based on our novel three-dimensional matrix positioning method.Typically,the core principle of the latter procedure was to put the MRI and ultrasound images into the same virtual coordinate system.Afterward,the targeted biopsy was transformed to target a coordinate for the suspected lesion in the MRI.Subsequently,patients were assessed for the presence/absence of prostate cancer or high-grade prostate cancer.According to our results,the overall detection rate of prostate cancer was 70.8%(68/96),and the detection rate of high-grade prostate cancer was 56.3%(54/96).Specifically,the detection rate of prostate cancer by systematic biopsy was 54.2%(52/96)and that by targeted biopsy was 59.4%(57/96;P=0.560).Clearly,the combined application of targeted biopsy could remarkably increase the detection rates of prostate cancer(P=0.025)and high-grade prostate cancer(P=0.009).Taken together,the findings of this study suggest that the combination of systematic biopsy with our three-dimensional matrix positioning-driven cognitive-targeted biopsy is superior to systematic biopsy in detecting prostate cancer and high-grade prostate cancer.