Comparison of Gleason score of Prostate Cancer at Ultrasound/MRI Fusion Target Biopsy vs. Systematic Transrectal Ultrasound Guided Biopsy with Final Gleason score at Radical Prostatectomy

Archive of urological research Pub Date : 2022-10-20 DOI:10.17352/aur.000039

Yu Jinxing, Falagario Ugo, Winks Sarah G, Angell Kendal, Fulcher Ann S, Turner Mary A, Jones Sterling, Kankaria Rohan, Smith Steven C

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Abstract

Purpose: To compare accuracy in predicting final Gleason Grade Group (GGG) of Prostate Cancer (PCa) of US/MRI fusion guided target (fBx) vs. systematic Transrectal Ultrasound-Guided (TRUS) biopsy, using histopathologic analysis at prostatectomy as the gold standard. Materials and methods: After obtaining IRB approval, we retrospectively reviewed records of patients who underwent Radical Prostatectomy (RP) from January 2014 through May 2019 with prior US/MRI fusion guided target or TRUS biopsy. The rates of upgrading (RP GGG > BX GGG), downgrading (RP GGG < BX GGG), and concordance (RP GGG = BX GGG) were compared between the fBx and TRUS groups. Age, PSA, PSA density, and prostate volume were also noted for all patients. Statistical analysis was utilized to assess the data. Results: A total of 348 men with complete clinical data were included in this study. The rate of downgrading and upgrading in the fBx group was less than in the TRUS biopsy group (14% vs. 19.6%, and 13.2% vs. 19.6%, respectively). The concordance rate was higher in the US-MR fBx group (72.9% vs. 60.7%, p < 0.05)) across all GGG. Notably, lower rates of concordance were found for GGG 1 (24.1%) and GGG 4 (3.6%) in the TRUS Bx group. Patients who underwent US-MR fBx had higher average PSA (9.4 vs. 6.5 ng/ml), higher PSA density (0.3 vs. 0.2 ng/ml2), and lower prostate volume (31 vs. 42 cc). Additionally, biopsy results showed a lower rate of GGG 1 (3.1% vs. 13.2%) and a higher rate of GGG 5 (14.7% vs. 5.5%) in the US-MR fBx group. Conclusions: Target biopsy has a higher GGG concordance compared to TRUS biopsy (72.9% vs. 60.7%, p < 0.05). In addition, there was less downgrading or upgrading of final PCa GGG in the fBx groups compared to TRUS Bx (14% vs. 19.6%, 13.2% vs. 19.6%, respectively). This finding may have important implications for treatment decisions.

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前列腺根治术中超声/MRI融合靶活检与经直肠超声引导活检最终Gleason评分的比较

目的:比较US/MRI融合引导靶标(fBx)与系统经直肠超声引导(TRUS)活检预测前列腺癌(PCa)最终Gleason分级组(GGG)的准确性，以前列腺切除术时的组织病理学分析为金标准。材料和方法:在获得IRB批准后，我们回顾性回顾了2014年1月至2019年5月期间接受根治性前列腺切除术(RP)的患者记录，这些患者先前接受了US/MRI融合引导的靶活检或TRUS活检。比较fBx组和TRUS组的升级率(RP GGG > BX GGG)、降级率(RP GGG < BX GGG)和一致性(RP GGG = BX GGG)。所有患者的年龄、PSA、PSA密度和前列腺体积也被记录下来。采用统计学方法对资料进行评价。结果:本研究共纳入临床资料完整的男性348例。fBx组的降级和升级率低于TRUS活检组(分别为14%对19.6%，13.2%对19.6%)。在所有GGG中，US-MR fBx组的符合率更高(72.9%比60.7%，p < 0.05)。值得注意的是，TRUS Bx组ggg1(24.1%)和ggg4(3.6%)的一致性率较低。接受US-MR fBx检查的患者平均PSA较高(9.4 vs. 6.5 ng/ml)， PSA密度较高(0.3 vs. 0.2 ng/ml2)，前列腺体积较低(31 vs. 42 cc)。此外，活检结果显示，在US-MR fBx组，GGG 1的发生率较低(3.1%对13.2%)，GGG 5的发生率较高(14.7%对5.5%)。结论:靶活检与TRUS活检相比GGG一致性更高(72.9% vs. 60.7%， p < 0.05)。此外，与TRUS Bx组相比，fBx组最终PCa GGG的降级或升级较少(分别为14%对19.6%，13.2%对19.6%)。这一发现可能对治疗决策具有重要意义。

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Archive of urological research

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