Abstract: PD11-09
Sources of Funding: none

Introduction

To evaluate the accuracy of real-time elastic fusion image-guided transperineal prostate biopsy with needle tracking of mechanical position-encoded stepper in the detection of the significant prostate cancer for the biopsy naive men.

Methods

The patients with PSA level less than 20 ng/ml who were suspected as having prostate cancer from mpMRI scans were recruited prospectively. Target biopsies for each cancer-suspicious lesion real-time elastic fusion image-guided transperineal prostate biopsy with needle tracking of mechanical position-encoded stepper (Figure) and 12-cores systematic biopsies using the BioJet^® system (D&K Technologies GmbH, Barum, Germany). Pathological findings of biopsy cores and whole mount specimen were analyzed.

Results

Two hundred fifty patients were included in the present study. Biopsy-proven significant cancer detection rate in the patients was 59% (148 of 250 patients). There was significantly different of the cancer detection rates in the patients between the target (58%, 145 of 250 patients) and systematic biopsy (34%, 86 of 250 patients) (p<0.0001). In targeted biopsy cores (n=527), biopsy-proven significant cancer detection rates (36% vs. 2.1%, p<0.0001), median positive core length (median 8mm vs. median 2mm, p<0.0001), median positive core percent (50% vs. 10%, p<0.0001), and median Gleason score (p<0.0001) were significantly higher compared with the results in systematic biopsy cores (n=3000). Biopsy-proven significant cancer detection rates of the targeted lesions with the Prostate Imaging and Reporting and Data System classification 3, 4, and 5 were 6.8%, 49%, and 80%, respectively. In whole mount specimen, the geographic locations in 96% of significant cancers were diagnosed before radical prostatectomy by both of targeted biopsy and mpMRI findings.

Conclusions

The biopsy-proven significant cancer detection rate using the present biopsy was significant higher, and the targeted biopsy cores had a significantly higher grade and larger length compared with systematic biopsies. The accuracy of geographic diagnosis of the significant cancer in the results shows the present biopsy method as a promising method.

Funding

none