Do Saturation Prostate Biopsies Provide Additional Clinically Significant Information in Patients with MRI Identified Lesions Sampled at the Same Time: Our Institutional Experience

Document Type

Conference Proceeding

Publication Date

3-1-2024

Publication Title

Lab Invest

Abstract

Background: Saturation prostate biopsies and multiparametric MRI (mpMRI) combined with fusion biopsy are novel approaches to detect clinically significant prostate cancer (PCa). The aim of this study is to report the results of a combined approach adopted in our institution. Design: All consecutive 233 patients who underwent combined saturation and fusion biopsy at our institution from 2020 to 2022 were included. Pathological and clinical information were collected from pathology and medical records. Clinically significant PCa was defined as group grade 2 (GG2) or higher. Cases were signed out by a specialized urologic pathologist. Results: Median age was 68 (43-88). Median PSA was 6 ng/mL (0.5-52.2). Median PSA density was 0.12 (0.01-1.18). Median number of region of interests (ROIs) was 1 (1-3). Median PiRAD score was 4 (3-5). Median number of saturation regions (SAT) was 22. The SAT were negative in 59 (25%) patients and showed clinically significant PCa in 118 (51%). The ROIs were negative in 58 (24.8%) patients and showed clinically significant PCa in 136 (58.6%). (table 1) Of the 59 patients who were benign in the SAT, 15 (25.4%) had clinically significant PCa in the ROIs. Of the 58 patients who were benign in the ROIs, 8 (13.8%) had clinically significant PCa in the SAT. Of the 56 patients who had GG1 PCa in the SAT, 25 (44.6%) had clinically significant PCa in the ROIs. Of the 37 patients who had GG1 PCa in the ROIs, 6 (16.2%) had clinically significant PCa in the SAT. Overall, of the 233, 159 (68.2%) had clinically significant PCa with the combined approach. Median length of largest tumor focus was 4 mm (0.2-14) in the SAT while it was 6.7 mm (0.2-43) in the ROIs. In the SAT, intraductal carcinoma of the prostate (IDCP) was found in 13 patients (5.6%), cribriform pattern 4 (CRIB) in 10 (4.3%) and extra prostatic extension (EPE) in 6 (2.6%). In the ROIs, IDCP was found in 13 patients (5.6%), CRIB in 18 (7.7%) and EPE in 3 (1.3%). No statistical significance was identified between the two approaches. Conclusions: In a previous study, we showed that 50.4% of the patients who underwent mpMRI fusion biopsy at our institution between 2015-2021 had clinically significant PCa. In this cohort with the combined approach, 68.2% of patients had clinically significant PCa. Our results also showed that SAT has higher tendency to find EPE 2.6% vs 1.3% in ROIs. Our findings suggest that adopting the combined approach may provide additional clinically significant information to mpMRI fusion biopsy alone.

Volume

104

Issue

3

First Page

S1029

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