Prebiopsy Magnetic Resonance Imaging Followed by Combination Biopsy for Prostate Cancer Diagnosis Is Associated with a Lower Risk of Biochemical Failure After Treatment Compared to Systematic Biopsy Alone
<b>Background:</b> Prostate cancer (PCa) diagnosis remains a complex field of study. Multiparametric magnetic resonance imaging (mpMRI) technology presents opportunities to enhance diagnostic precision. While recent advances in imaging and biopsy techniques show promise, the oncological...
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MDPI AG
2025-03-01
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| Online Access: | https://www.mdpi.com/2075-4418/15/6/698 |
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| author | Shima Tayebi Samuel Tremblay Jason Koehler Alon Lazarovich Fernando Blank Wei-Wen Hsu Sadhna Verma Abhinav Sidana |
| author_facet | Shima Tayebi Samuel Tremblay Jason Koehler Alon Lazarovich Fernando Blank Wei-Wen Hsu Sadhna Verma Abhinav Sidana |
| author_sort | Shima Tayebi |
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| description | <b>Background:</b> Prostate cancer (PCa) diagnosis remains a complex field of study. Multiparametric magnetic resonance imaging (mpMRI) technology presents opportunities to enhance diagnostic precision. While recent advances in imaging and biopsy techniques show promise, the oncological implications of prebiopsy magnetic resonance imaging (MRI) and combination biopsy (ComBx) are not fully understood. This retrospective study evaluates the potential clinical impact of prebiopsy MRI and ComBx on PCa treatment outcomes. <b>Methods:</b> We conducted a comprehensive review of treatment-naïve patients undergoing prostate biopsy and subsequent radiation therapy (RT) or radical prostatectomy at the University of Cincinnati Health Center (2014–2020). Patients were categorized into two cohorts: those with prebiopsy mpMRI and ComBx versus those with systematic biopsy (SBx) alone. Patients with prostate-specific antigen (PSA) > 20 ng/mL were excluded. Biochemical recurrence (BCR) was defined as PSA ≥ 0.2 ng/mL post-prostatectomy or ≥2 ng/mL above nadir post-RT. <b>Results:</b> This study included 518 patients (189 SBx, 329 ComBx) with a median follow-up of 19.1 months. Median patient ages were 65.9 years (SBx) and 64.6 years (ComBx). The overall BCR rate was 10% with significantly lower rates in the ComBx group compared to SBx (6.4% vs. 16.4%, <i>p</i> < 0.001). Multivariable Cox regression analysis showed patients undergoing prebiopsy mpMRI with ComBx were 63% less likely to experience BCR (HR: 0.37, 95%CI 0.20–0.70, <i>p</i> = 0.002). <b>Conclusions:</b> Prebiopsy MRI followed by ComBx demonstrated lower BCR rates, suggesting improved PCa diagnosis and risk stratification. These findings highlight the potential of advanced imaging and biopsy techniques to benefit the management of PCa. Further longitudinal studies are needed to confirm the long-term clinical benefits of this approach. |
| format | Article |
| id | doaj-art-cdaa993a6da54db899318a21008c00dc |
| institution | Kabale University |
| issn | 2075-4418 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj-art-cdaa993a6da54db899318a21008c00dc2025-08-20T03:43:26ZengMDPI AGDiagnostics2075-44182025-03-0115669810.3390/diagnostics15060698Prebiopsy Magnetic Resonance Imaging Followed by Combination Biopsy for Prostate Cancer Diagnosis Is Associated with a Lower Risk of Biochemical Failure After Treatment Compared to Systematic Biopsy AloneShima Tayebi0Samuel Tremblay1Jason Koehler2Alon Lazarovich3Fernando Blank4Wei-Wen Hsu5Sadhna Verma6Abhinav Sidana7Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USASection of Urology, Department of Surgery, The University of Chicago Medicine & Biological Sciences, 5841 S. Maryland Ave, Rm P-217, Chicago, IL 60637, USACollege of Medicine, University of Cincinnati, Cincinnati, OH 45267, USASection of Urology, Department of Surgery, The University of Chicago Medicine & Biological Sciences, 5841 S. Maryland Ave, Rm P-217, Chicago, IL 60637, USADivision of Urology, Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USADivision of Biostatistics and Bioinformatics, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USADepartment of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USASection of Urology, Department of Surgery, The University of Chicago Medicine & Biological Sciences, 5841 S. Maryland Ave, Rm P-217, Chicago, IL 60637, USA<b>Background:</b> Prostate cancer (PCa) diagnosis remains a complex field of study. Multiparametric magnetic resonance imaging (mpMRI) technology presents opportunities to enhance diagnostic precision. While recent advances in imaging and biopsy techniques show promise, the oncological implications of prebiopsy magnetic resonance imaging (MRI) and combination biopsy (ComBx) are not fully understood. This retrospective study evaluates the potential clinical impact of prebiopsy MRI and ComBx on PCa treatment outcomes. <b>Methods:</b> We conducted a comprehensive review of treatment-naïve patients undergoing prostate biopsy and subsequent radiation therapy (RT) or radical prostatectomy at the University of Cincinnati Health Center (2014–2020). Patients were categorized into two cohorts: those with prebiopsy mpMRI and ComBx versus those with systematic biopsy (SBx) alone. Patients with prostate-specific antigen (PSA) > 20 ng/mL were excluded. Biochemical recurrence (BCR) was defined as PSA ≥ 0.2 ng/mL post-prostatectomy or ≥2 ng/mL above nadir post-RT. <b>Results:</b> This study included 518 patients (189 SBx, 329 ComBx) with a median follow-up of 19.1 months. Median patient ages were 65.9 years (SBx) and 64.6 years (ComBx). The overall BCR rate was 10% with significantly lower rates in the ComBx group compared to SBx (6.4% vs. 16.4%, <i>p</i> < 0.001). Multivariable Cox regression analysis showed patients undergoing prebiopsy mpMRI with ComBx were 63% less likely to experience BCR (HR: 0.37, 95%CI 0.20–0.70, <i>p</i> = 0.002). <b>Conclusions:</b> Prebiopsy MRI followed by ComBx demonstrated lower BCR rates, suggesting improved PCa diagnosis and risk stratification. These findings highlight the potential of advanced imaging and biopsy techniques to benefit the management of PCa. Further longitudinal studies are needed to confirm the long-term clinical benefits of this approach.https://www.mdpi.com/2075-4418/15/6/698prostate cancermagnetic resonance imagingoncological outcomesbiochemical failure |
| spellingShingle | Shima Tayebi Samuel Tremblay Jason Koehler Alon Lazarovich Fernando Blank Wei-Wen Hsu Sadhna Verma Abhinav Sidana Prebiopsy Magnetic Resonance Imaging Followed by Combination Biopsy for Prostate Cancer Diagnosis Is Associated with a Lower Risk of Biochemical Failure After Treatment Compared to Systematic Biopsy Alone Diagnostics prostate cancer magnetic resonance imaging oncological outcomes biochemical failure |
| title | Prebiopsy Magnetic Resonance Imaging Followed by Combination Biopsy for Prostate Cancer Diagnosis Is Associated with a Lower Risk of Biochemical Failure After Treatment Compared to Systematic Biopsy Alone |
| title_full | Prebiopsy Magnetic Resonance Imaging Followed by Combination Biopsy for Prostate Cancer Diagnosis Is Associated with a Lower Risk of Biochemical Failure After Treatment Compared to Systematic Biopsy Alone |
| title_fullStr | Prebiopsy Magnetic Resonance Imaging Followed by Combination Biopsy for Prostate Cancer Diagnosis Is Associated with a Lower Risk of Biochemical Failure After Treatment Compared to Systematic Biopsy Alone |
| title_full_unstemmed | Prebiopsy Magnetic Resonance Imaging Followed by Combination Biopsy for Prostate Cancer Diagnosis Is Associated with a Lower Risk of Biochemical Failure After Treatment Compared to Systematic Biopsy Alone |
| title_short | Prebiopsy Magnetic Resonance Imaging Followed by Combination Biopsy for Prostate Cancer Diagnosis Is Associated with a Lower Risk of Biochemical Failure After Treatment Compared to Systematic Biopsy Alone |
| title_sort | prebiopsy magnetic resonance imaging followed by combination biopsy for prostate cancer diagnosis is associated with a lower risk of biochemical failure after treatment compared to systematic biopsy alone |
| topic | prostate cancer magnetic resonance imaging oncological outcomes biochemical failure |
| url | https://www.mdpi.com/2075-4418/15/6/698 |
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