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Original Research

Open Access

Saturation target biopsy can overcome the learning curve of magnetic resonance imaging/ultrasound fusion biopsy of the prostate

  • Po-Fan Hsieh1,2,3,†,
  • Tian-You Chang1,†,
  • Wei-Ching Lin2,4,
  • Han Chang5
  • Chao-Hsiang Chang1
  • Chi-Ping Huang1,2,
  • Chi-Rei Yang1
  • Wen-Chi Chen1
  • Yi-Huei Chang1
  • Yu-De Wang1
  • Wen-Chin Huang3,*,
  • Hsi-Chin Wu1,2,6,*,

1Department of Urology, China Medical University Hospital, 40447 Taichung, Taiwan

2School of Medicine, China Medical University, 40402 Taichung, Taiwan

3Graduate Institute of Biomedical Sciences, School of Medicine, China Medical University, 40402 Taichung, Taiwan

4Department of Radiology, China Medical University Hospital, 40447 Taichung, Taiwan

5Department of Pathology, China Medical University Hospital, 40447 Taichung, Taiwan

6Department of Urology, China Medical University Beigang Hospital, Beigang, 651012 Yunlin, Taiwan

DOI: 10.31083/j.jomh1806127 Vol.18,Issue 6,June 2022 pp.1-6

Published: 30 June 2022

*Corresponding Author(s): Wen-Chin Huang E-mail: huangwc@mail.cmu.edu.tw
*Corresponding Author(s): Hsi-Chin Wu E-mail: wuhc4746@gmail.com

† These authors contributed equally.

Abstract

Background: Magnetic resonance imaging (MRI) has emerged as a promising tool for diagnosing prostate cancer. Magnetic resonance imaging/ultrasound (MRI/US) fusion target biopsy (TB) can increase the detection rate of clinically significant prostate cancer (csPC) and decrease the detection rate of clinically insignificant PC (ciPC) compared with systematic biopsy (SB). However, the MRI/US fusion biopsy had a steep learning curve. A new biopsy template, saturation TB (sTB), was reported to provide a cancer detection rate comparable to that of the combination of TB and SB. This study reports our experience with MRI/US fusion prostate biopsy and investigates the role of sTB in MRI/US fusion biopsy. Methods: We prospectively enrolled males with elevated prostate-specific antigen or abnormal digital rectal examination (DRE) and Prostate Imaging Reporting & Data System (PI-RADS) score 3 who underwent MRI/US fusion prostate biopsy in a tertiary referral center. We compared cancer detection rates among different biopsy templates, including TB, SB, sTB, and the combination of TB and SB. The biopsy results and complications were recorded. Results: The detection rate of csPC by sTB was significantly higher than that of TB (53% vs. 44%; p = 0.008) or SB (53% vs. 43%; p = 0.002). The median biopsy cores were 6, 15, and 26 for TB, sTB, and the combination of TB and SB, respectively. In other words, sTB could decrease 11 biopsy cores without compromising the cancer detection rate compared with the combination of TB and SB. There were no Clavien-Dindo score of 3 complications in any of the patients. Conclusion: The sTB template can overcome targeting errors during MRI/US fusion biopsy, offering a cancer detection rate equal to the combination of TB and SB with reduced biopsy cores.


Keywords

Learning curve; Magnetic resonance imaging (MRI); MRI-ultrasound fusion; Prostate cancer; Target biopsy


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Po-Fan Hsieh,Tian-You Chang,Wei-Ching Lin,Han Chang,Chao-Hsiang Chang,Chi-Ping Huang,Chi-Rei Yang,Wen-Chi Chen,Yi-Huei Chang,Yu-De Wang,Wen-Chin Huang,Hsi-Chin Wu. Saturation target biopsy can overcome the learning curve of magnetic resonance imaging/ultrasound fusion biopsy of the prostate. Journal of Men's Health. 2022. 18(6);1-6.

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