Detection of extraprostatic extension by transperineal multiparametric magnetic resonance imaging-ultrasound fusion targeted combined with systemic template prostate biopsy

Diagnostic Pathology

Research

Ting Zhao¹  Hao-Wen Chuang²  Chin-Lee Wu³  Shulin Wu³  Mukesh Harisinghani⁴  Adam S. Feldman⁵  Michelle M. Kim⁵  Douglas M. Dahl⁵  Sharron X. Lin⁵ 

[1] Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA;Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA;Department of Pathology and Laboratory Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, TW, Taiwan;Institute of Oral Biology, School of Dentistry, National Yang Ming Chiao Tung University, Taipei, TW, Taiwan;Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA;Department of Urology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA;Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA;Department of Urology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA;

关键词: Extraprostatic extension;    Prostate cancer;    Transperineal;    Transrectal;    Fusion biopsy;    Template;   

DOI  :  10.1186/s13000-023-01386-w

 received in 2023-02-12, accepted in 2023-08-21,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundExtraprostatic extension (EPE) of prostate cancer (PCa) on transrectal (TR) needle core biopsy (Bx) is a rare histopathological finding that can help in clinical decision-making. The detection efficiency of the transperineal (TP) approach is yet to be explored.MethodsWe retrospectively reviewed 2848 PCa cases using concomitant systemic template biopsy (SBx) and multiparametric magnetic resonance imaging (MRI)-ultrasound fusion-targeted biopsy (TBx) using the TR (n = 1917) or TP (n = 931) approach at our institution between January 2015 and July 2022. We assessed and compared clinical, MRI, and biopsy characteristics using different approaches (TP and TR) and methods (SBx and TBx).ResultsIn total, 40 EPE cases were identified (40/2848, 1.4%). TP showed a significantly higher EPE detection rate compared to TR in SBx (TR:0.7% vs. TP:1.6%; p = 0.028) and TBx (TR:0.5% vs. TP:1.2%; p = 0.033), as well as the combined methods (2.1% vs. 1.1%, p = 0.019). A significantly higher incidence of EPEs was found at non-base sites in TP than in TR (76.7% vs. 50%, p = 0.038). SBx showed a higher EPE detection rate than TBx; however, the difference was not statistically significant. TP showed higher prostate-specific antigen density (0.35 vs. 0.17, p = 0.005), higher frequency of GG4-5 in the cores with EPE (65.0% vs. 50.0%, p = 0.020), and more PCa-positive SBx cores (10 vs. 8, p = 0.023) compared to the TR.ConclusionsTP may improve EPE detection compared with TR and should be applied to patients with adverse pre-biopsy features.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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