MP48-08 EARLY OUTCOMES OF COMBINATION MRI-TARGETED AND SATURATION TRANS-PERINEAL BIOPSY IN RESTAGING LOW-RISK PROSTATE CANCER FOR ACTIVE SURVEILLANCE

Abstract

You have accessJournal of UrologyProstate Cancer: Detection and Screening I1 Apr 2015MP48-08 EARLY OUTCOMES OF COMBINATION MRI-TARGETED AND SATURATION TRANS-PERINEAL BIOPSY IN RESTAGING LOW-RISK PROSTATE CANCER FOR ACTIVE SURVEILLANCE Kae Jack Tay, Kenneth Chen, Yan Mee Law, Henry Ho, John Yuen, and Christopher Cheng Kae Jack TayKae Jack Tay More articles by this author , Kenneth ChenKenneth Chen More articles by this author , Yan Mee LawYan Mee Law More articles by this author , Henry HoHenry Ho More articles by this author , John YuenJohn Yuen More articles by this author , and Christopher ChengChristopher Cheng More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1682AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES In low-risk prostate cancer, we investigate if a strategy of combination staging-biopsy (CSB) of robotic transperineal saturation biopsy (rTPB) and MRI-targeted biopsy (MRI-TB) better classifies these patients for treatment options. METHODS This IRB-approved, prospective study included men with low-risk prostate cancer (PSA of ≤ 10 ng/ml, Gleason score ≤ 6, clinically ≤T2a) diagnosed on conventional transrectal ultrasound-guided (TRUS) biopsy. Patients first underwent multiparametric-MRI of the prostate ≥ 6 weeks after initial TRUS biopsy. A single dedicated radiologist then marked and assigned a PIRADS score to each suspicious lesion on a 24-sector template grid of the prostate. Biopsies were performed via transperineal route under general anaesthesia with iSR'obot™ Mona Lisa, a robotic platform with maximal coverage of prostate using real-time 3D-ultrasound technology. Systematic rTPB was first performed by a surgeon blinded to the MRI findings. Next, the MRI positive sector was targeted with 6 biopsy cores by a second surgeon. Our primary outcome was upgrading of Gleason score at CSB compared to initial TRUS biopsy. The secondary outcome was proportion of upgrading at MRI-TB compared to rTPB. RESULTS The 15 Singaporean men included have a mean age of 65.5 years. The mean PSA at diagnosis was 6.6 ± 2.0 ng/ml and the mean prostate volume was 32.1 ± 13.4 cc. At rTPB, a mean of 26.5 ± 9.1 cores were taken per patient, with a mean biopsy intensity of 0.87 ± 0.17 cores/ml of prostate. A total of 52 sectors were positive on MRI, of which 17 were PIRADS 5, 23 were PIRADS 4 and 12 were PIRADS 3. On MRI-TB, 14 lesions were Gleason ≥7 and all were PIRADS 5. Overall, CSB up-classify 5 patients (33.3%) - 2 by MRI-TB alone, 1 by rTPB alone and 2 by both modalities. CONCLUSIONS CSB upgrades a third of our patients presumed to be low-risk by initial TRUS biopsy. MR-TB detects 80 % of these patients. In patient with PIRADS 5 score, MRI-TB detects all Gleason ≥7 cancers. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e597 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kae Jack Tay More articles by this author Kenneth Chen More articles by this author Yan Mee Law More articles by this author Henry Ho More articles by this author John Yuen More articles by this author Christopher Cheng More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...