Optimal PSA Threshold for Obtaining MRI-Fusion Biopsy in Biopsy-Naïve Patients
Objective. The study investigates the prostate-specific antigen threshold for adding targeted, software-based, magnetic resonance imaging-ultrasound fusion biopsy during a standard 12-core biopsy in biopsy-naïve patients. It secondarily explores whether the targeted biopsy is necessary in setting of...
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| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2021-01-01
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| Series: | Prostate Cancer |
| Online Access: | http://dx.doi.org/10.1155/2021/5531511 |
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| author | Luke L. Wang Brandon L. Henslee Peter B. Sam Chad A. LaGrange Shawna L. Boyle |
| author_facet | Luke L. Wang Brandon L. Henslee Peter B. Sam Chad A. LaGrange Shawna L. Boyle |
| author_sort | Luke L. Wang |
| collection | DOAJ |
| description | Objective. The study investigates the prostate-specific antigen threshold for adding targeted, software-based, magnetic resonance imaging-ultrasound fusion biopsy during a standard 12-core biopsy in biopsy-naïve patients. It secondarily explores whether the targeted biopsy is necessary in setting of abnormal digital rectal examination. Methods. 260 patients with suspected localized prostate cancer with no prior biopsy underwent prostate magnetic resonance imaging and were found to have Prostate Imaging Reporting and Data System score ≥ 3 lesion(s). All 260 patients underwent standard 12-core biopsy and targeted biopsy during the same session. Clinically significant cancer was Gleason ≥3 + 4. Results. Percentages of patients with prostate-specific antigen 0–1.99, 2–3.99, 4–4.99, 5–5.99, 6–9.99, and ≥10 were 3.0%, 4.7%, 20.8%, 16.9%, 37.7%, and 16.9%, respectively. Cumulative frequency of clinically significant prostate cancer increased with the addition of targeted biopsy compared with standard biopsy alone across all prostate-specific antigen ranges. The difference in clinically significant cancer detection between targeted plus standard biopsy compared to standard biopsy alone becomes statistically significant at prostate-specific antigen >4.3 (p=0.031). At this threshold, combination biopsy detected 20 clinically significant prostate cancers, while standard detected 14 with 88% sensitivity and 20% specificity. Excluding targeted biopsy in setting of a positive digital rectal exam would save 12.3% magnetic resonance imaging and miss 1.8% clinically significant cancers in our cohort. Conclusions. In biopsy-naïve patients, at prostate-specific antigen >4.3, there is a significant increase in clinically significant prostate cancer detection when targeted biopsy is added to standard biopsy. Obtaining standard biopsy alone in patients with abnormal digital rectal examinations would miss 1.8% clinically significant cancers in our cohort. |
| format | Article |
| id | doaj-art-af523adbd5bf4a51abe62ada0f52ef09 |
| institution | Kabale University |
| issn | 2090-3111 2090-312X |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Prostate Cancer |
| spelling | doaj-art-af523adbd5bf4a51abe62ada0f52ef092025-08-20T03:39:06ZengWileyProstate Cancer2090-31112090-312X2021-01-01202110.1155/2021/55315115531511Optimal PSA Threshold for Obtaining MRI-Fusion Biopsy in Biopsy-Naïve PatientsLuke L. Wang0Brandon L. Henslee1Peter B. Sam2Chad A. LaGrange3Shawna L. Boyle4Division of Urology, University of Nebraska Medical Center, Omaha, NE 68198, USADivision of Urologic Surgery, University of Missouri School of Medicine, Columbia, MO 65212, USADivision of Urology, University of New Mexico School of Medicine, Albuquerque, NM 87106, USADivision of Urology, University of Nebraska Medical Center, Omaha, NE 68198, USADivision of Urology, University of Nebraska Medical Center, Omaha, NE 68198, USAObjective. The study investigates the prostate-specific antigen threshold for adding targeted, software-based, magnetic resonance imaging-ultrasound fusion biopsy during a standard 12-core biopsy in biopsy-naïve patients. It secondarily explores whether the targeted biopsy is necessary in setting of abnormal digital rectal examination. Methods. 260 patients with suspected localized prostate cancer with no prior biopsy underwent prostate magnetic resonance imaging and were found to have Prostate Imaging Reporting and Data System score ≥ 3 lesion(s). All 260 patients underwent standard 12-core biopsy and targeted biopsy during the same session. Clinically significant cancer was Gleason ≥3 + 4. Results. Percentages of patients with prostate-specific antigen 0–1.99, 2–3.99, 4–4.99, 5–5.99, 6–9.99, and ≥10 were 3.0%, 4.7%, 20.8%, 16.9%, 37.7%, and 16.9%, respectively. Cumulative frequency of clinically significant prostate cancer increased with the addition of targeted biopsy compared with standard biopsy alone across all prostate-specific antigen ranges. The difference in clinically significant cancer detection between targeted plus standard biopsy compared to standard biopsy alone becomes statistically significant at prostate-specific antigen >4.3 (p=0.031). At this threshold, combination biopsy detected 20 clinically significant prostate cancers, while standard detected 14 with 88% sensitivity and 20% specificity. Excluding targeted biopsy in setting of a positive digital rectal exam would save 12.3% magnetic resonance imaging and miss 1.8% clinically significant cancers in our cohort. Conclusions. In biopsy-naïve patients, at prostate-specific antigen >4.3, there is a significant increase in clinically significant prostate cancer detection when targeted biopsy is added to standard biopsy. Obtaining standard biopsy alone in patients with abnormal digital rectal examinations would miss 1.8% clinically significant cancers in our cohort.http://dx.doi.org/10.1155/2021/5531511 |
| spellingShingle | Luke L. Wang Brandon L. Henslee Peter B. Sam Chad A. LaGrange Shawna L. Boyle Optimal PSA Threshold for Obtaining MRI-Fusion Biopsy in Biopsy-Naïve Patients Prostate Cancer |
| title | Optimal PSA Threshold for Obtaining MRI-Fusion Biopsy in Biopsy-Naïve Patients |
| title_full | Optimal PSA Threshold for Obtaining MRI-Fusion Biopsy in Biopsy-Naïve Patients |
| title_fullStr | Optimal PSA Threshold for Obtaining MRI-Fusion Biopsy in Biopsy-Naïve Patients |
| title_full_unstemmed | Optimal PSA Threshold for Obtaining MRI-Fusion Biopsy in Biopsy-Naïve Patients |
| title_short | Optimal PSA Threshold for Obtaining MRI-Fusion Biopsy in Biopsy-Naïve Patients |
| title_sort | optimal psa threshold for obtaining mri fusion biopsy in biopsy naive patients |
| url | http://dx.doi.org/10.1155/2021/5531511 |
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