A Diagnostic Accuracy Study of Targeted and Systematic Biopsies to Detect Clinically Significant Prostate Cancer, including a Model for the Partial Omission of Systematic Biopsies
Morote Robles, Juan (Universitat Autònoma de Barcelona. Departament de Cirurgia)
Picola, Natàlia (Hospital Universitari de Bellvitge)
Muñoz-Rodríguez, Jesús (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Paesano, Nahuel (Clínica Creu Blanca (Barcelona, Catalunya))
Ruiz-Plazas, Xavier (Hospital Universitari Joan XXIII de Tarragona)
Muñoz-Rivero, Marta V. (Hospital Universitari Arnau de Vilanova)
Celma, Ana (Hospital Universitari Vall d'Hebron)
García-de Manuel, Gemma (Hospital Universitari de Girona Doctor Josep Trueta)
Aisian, Ignacio (Hospital Clínic i Provincial de Barcelona)
Servian, Pol (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Abascal, Jose Maria (Universitat Pompeu Fabra)

Date:	2023
Abstract:	The primary objective of this study was to analyse the current accuracy of targeted and systematic prostate biopsies in detecting csPCa. A secondary objective was to determine whether there are factors predicting the finding of csPCa in targeted biopsies and, if so, to explore the utility of a predictive model for csPCa detection only in targeted biopsies. We analysed 2122 men with suspected PCa, serum PSA > 3 ng/mL, and/or a suspicious digital rectal examination (DRE), who underwent targeted and systematic biopsies between 2021 and 2022. CsPCa (grade group 2 or higher) was detected in 1026 men (48. 4%). Discrepancies in csPCa detection in targeted and systematic biopsies were observed in 49. 6%, with 13. 9% of csPCa cases being detected only in systematic biopsies and 35. 7% only in targeted biopsies. A predictive model for csPCa detection only in targeted biopsies was developed from the independent predictors age (years), prostate volume (mL), PI-RADS score (3 to 5), mpMRI Tesla (1. 5 vs. 3. 0), TRUS-MRI fusion image technique (cognitive vs. software), and prostate biopsy route (transrectal vs. transperineal). The csPCa discrimination ability of targeted biopsies showed an AUC of 0. 741 (95% CI 0. 721-0. 762). The avoidance rate of systematic prostate biopsies went from 0. 5% without missing csPCa to 18. 3% missing 4. 6% of csPCa cases. We conclude that the csPCa diagnostic accuracy of targeted biopsies is higher than that of systematic biopsies. However, a significant rate of csPCa remains detected only in systematic biopsies. A predictive model for the partial omission of systematic biopsies was developed.
Grants:	Instituto de Salud Carlos III PI20/01666
Note:	UDTAULI
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Clinically significant prostate cancer detection ; Systematic biopsy ; Targeted biopsy ; Prostate biopsy concordance
Published in:	Cancers, Vol. 15 (september 2023) , ISSN 2072-6694

DOI: 10.3390/cancers15184543
PMID: 37760511

12 p, 597.5 KB

The record appears in these collections:
Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Parc Taulí Research and Innovation Institute (I3PT
Articles > Research articles
Articles > Published articles