Fusion Biopsy, not Cognitive, Is the New Gold Standard

To date, although some benefits resulting from a software-guided technique are undeniable, no clear superiority of fusion over cognitive targeted biopsy (COG-TB) has been supported by strong evidence. We discuss potential causes of trials failing to show the superiority of fusion TB (FUS-TB) and hig...

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Main Authors: Alessandro Marquis, Giancarlo Marra, Paolo Gontero
Format: Article
Language:English
Published: MDPI AG 2023-03-01
Series:Société Internationale d’Urologie Journal
Subjects:
Online Access:https://siuj.org/index.php/siuj/article/download/253/197
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author Alessandro Marquis
Giancarlo Marra
Paolo Gontero
author_facet Alessandro Marquis
Giancarlo Marra
Paolo Gontero
author_sort Alessandro Marquis
collection DOAJ
description To date, although some benefits resulting from a software-guided technique are undeniable, no clear superiority of fusion over cognitive targeted biopsy (COG-TB) has been supported by strong evidence. We discuss potential causes of trials failing to show the superiority of fusion TB (FUS-TB) and highlight its advantages over the cognitive approach.One possible reason why current literature showed contradictory evidence in supporting FUS-TB may be the lack of high-quality well-designed trials. Indeed, most of the studies addressing this issue have considerable limitations, such as underpowering, small sample size, lack of randomization, and poor generalizability. A second reason may be the inclusion in the majority of trials of a wide spectrum of MRI-lesions, a scenario in which the benefits of FUS-TB may be less evident. In fact, some of the few studies considering smaller targets demonstrated higher accuracy for the FUS technique. As concerns the advantages of FUS-TB, the opportunity offered by some fusion systems of storing information useful for planning and/or follow-up active surveillance, focal therapy, and radical prostatectomy, as well as a reported faster learning curve, are strong points supporting the fusion approach.In conclusion, the potential advantages when targeting smaller lesions together with the storage capability to guide patient management after the biopsy and an easier learning curve may make the FUS approach the more appropriate technique for performing TB.
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spelling doaj-art-a2c58f16fb0a474eb6e8bd69249dc5622025-08-20T03:38:19ZengMDPI AGSociété Internationale d’Urologie Journal2563-64992023-03-014214214410.48083//RYRF4858Fusion Biopsy, not Cognitive, Is the New Gold StandardAlessandro Marquis Giancarlo Marra Paolo GonteroTo date, although some benefits resulting from a software-guided technique are undeniable, no clear superiority of fusion over cognitive targeted biopsy (COG-TB) has been supported by strong evidence. We discuss potential causes of trials failing to show the superiority of fusion TB (FUS-TB) and highlight its advantages over the cognitive approach.One possible reason why current literature showed contradictory evidence in supporting FUS-TB may be the lack of high-quality well-designed trials. Indeed, most of the studies addressing this issue have considerable limitations, such as underpowering, small sample size, lack of randomization, and poor generalizability. A second reason may be the inclusion in the majority of trials of a wide spectrum of MRI-lesions, a scenario in which the benefits of FUS-TB may be less evident. In fact, some of the few studies considering smaller targets demonstrated higher accuracy for the FUS technique. As concerns the advantages of FUS-TB, the opportunity offered by some fusion systems of storing information useful for planning and/or follow-up active surveillance, focal therapy, and radical prostatectomy, as well as a reported faster learning curve, are strong points supporting the fusion approach.In conclusion, the potential advantages when targeting smaller lesions together with the storage capability to guide patient management after the biopsy and an easier learning curve may make the FUS approach the more appropriate technique for performing TB.https://siuj.org/index.php/siuj/article/download/253/197prostate biopsytargeted prostate biopsyfusion prostate biopsycognitive prostate biopsyprostate cancer
spellingShingle Alessandro Marquis
Giancarlo Marra
Paolo Gontero
Fusion Biopsy, not Cognitive, Is the New Gold Standard
Société Internationale d’Urologie Journal
prostate biopsy
targeted prostate biopsy
fusion prostate biopsy
cognitive prostate biopsy
prostate cancer
title Fusion Biopsy, not Cognitive, Is the New Gold Standard
title_full Fusion Biopsy, not Cognitive, Is the New Gold Standard
title_fullStr Fusion Biopsy, not Cognitive, Is the New Gold Standard
title_full_unstemmed Fusion Biopsy, not Cognitive, Is the New Gold Standard
title_short Fusion Biopsy, not Cognitive, Is the New Gold Standard
title_sort fusion biopsy not cognitive is the new gold standard
topic prostate biopsy
targeted prostate biopsy
fusion prostate biopsy
cognitive prostate biopsy
prostate cancer
url https://siuj.org/index.php/siuj/article/download/253/197
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AT giancarlomarra fusionbiopsynotcognitiveisthenewgoldstandard
AT paologontero fusionbiopsynotcognitiveisthenewgoldstandard