Systematic and MRI-Cognitive Targeted Transperineal Prostate Biopsy Accuracy in Detecting Clinically Significant Prostate Cancer after Previous Negative Biopsy and Persisting Suspicion of Malignancy
Abstract
:1. Introduction
2. Materials and Methods
2.1. Patient Population
2.2. Imaging
2.3. Biopsy
2.4. Histopathology
2.5. Statistics
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Patient Characteristics | N |
Age, mean (SD), years | 62 (5.9) |
PSA at first biopsy, median (IQR), ng/mL | 5.6 (4.8–6.17) |
PSA at TTPM biopsy, median (IQR), ng/mL | 7.6 (5.6–10.9) |
Prostate volume at TTPM biopsy, median (IQR), mL | 62 (46.9–87.5) |
PSAD at TTPM biopsy, median (IQR), ng/mL/mL | 0.121 (0.084–0.187) |
Days between the first TRUS biopsy and repeated TTPM biopsy, mean (IQR), days | 1081 (708–2064) |
PI-RADS v2 category | N (%) |
PI-RADS 1–2, n (%) | 38 (19%) |
PI-RADS 3, n (%) | 27 (13.5%) |
PI-RADS 4, n (%) | 102 (51%) |
PI-RADS 5, n (%) | 33 (16.5%) |
Gleason pattern | N (%) |
Benign, n (%) | 98 (49%) |
Gleason 3 + 3, n (%) | 78 (39%) |
Gleason 3 + 4, n (%) | 18 (9%) |
Gleason 4 + 3, n (%) | 6 (3%) |
Clinically significant cancer at TTPM biopsy, n (%) | 31 (15.5%) |
Biopsy Type on Which PC Was Found for Each Patient | PI-RADS v.2 | (PI-RADS < 3) | (PI-RADS ≥ 3) | Total | |||
---|---|---|---|---|---|---|---|
PC | csPC | PC | csPC | PC | csPC | ||
Systematic, n (%) | 16 | 3 | 38 | 17 (10.5%) | 54 | 20 | |
Targeted, n (%) | 3 | - | - | 2 | 1 (0.6%) | 9 | 8 |
4 | - | - | 3 | 4 (2.7%) | |||
5 | - | - | 4 | 3 (1.8%) | |||
Systematic + Targeted, n (%) | 3 | - | - | 5 | - | 39 | 3 |
4 | - | - | 22 | 2 (1.2%) | |||
5 | - | - | 12 | 1 (0.6%) | |||
No Cancer, n | 22 | 76 | 98 |
Parameter | Beta Coefficient | SE | Walds Statistics | Odds Ratio | Odds Ratio 95% CI | p Value |
---|---|---|---|---|---|---|
Baseline PSA | 0.13 | 0.06 | 5.31 | 1.14 | 1.02–1.27 | 0.021 |
PSAD | 2.75 | 1.04 | 7.04 | 15.68 | 2.05–119.64 | 0.008 |
Prostate volume | –0.04 | 0.01 | 15.18 | 0.96 | 0.94–0.98 | <0.001 |
PiRADS ≥ 3 | 0.442 | 0.668 | 0.437 | 1.56 | 0.42–5.76 | 0.509 |
PSA density > 0.15 | 1.759 | 0.438 | 16.162 | 5.81 | 2.46–13.69 | <0.001 |
PiRADS ≥ 3 and PSA density > 0.15 | 1.817 | 0.423 | 18.463 | 6.15 | 2.69–14.09 | <0.001 |
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Vėželis, A.; Platkevičius, G.; Kinčius, M.; Gumbys, L.; Naruševičiūtė, I.; Briedienė, R.; Petroška, D.; Ulys, A.; Jankevičius, F. Systematic and MRI-Cognitive Targeted Transperineal Prostate Biopsy Accuracy in Detecting Clinically Significant Prostate Cancer after Previous Negative Biopsy and Persisting Suspicion of Malignancy. Medicina 2021, 57, 57. https://doi.org/10.3390/medicina57010057
Vėželis A, Platkevičius G, Kinčius M, Gumbys L, Naruševičiūtė I, Briedienė R, Petroška D, Ulys A, Jankevičius F. Systematic and MRI-Cognitive Targeted Transperineal Prostate Biopsy Accuracy in Detecting Clinically Significant Prostate Cancer after Previous Negative Biopsy and Persisting Suspicion of Malignancy. Medicina. 2021; 57(1):57. https://doi.org/10.3390/medicina57010057
Chicago/Turabian StyleVėželis, Alvydas, Gediminas Platkevičius, Marius Kinčius, Liutauras Gumbys, Ieva Naruševičiūtė, Rūta Briedienė, Donatas Petroška, Albertas Ulys, and Feliksas Jankevičius. 2021. "Systematic and MRI-Cognitive Targeted Transperineal Prostate Biopsy Accuracy in Detecting Clinically Significant Prostate Cancer after Previous Negative Biopsy and Persisting Suspicion of Malignancy" Medicina 57, no. 1: 57. https://doi.org/10.3390/medicina57010057