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Open Access 01-04-2021 | Prostate Cancer | Original Article

Effect of information on prostate biopsy history on biopsy outcomes in the era of MRI-targeted biopsies

Authors: Anna Lantz, Erik Skaaheim Haug, Wolfgang Picker, Alessio Crippa, Fredrik Jäderling, Ashkan Mortezavi, Tobias Nordström

Published in: World Journal of Urology | Issue 4/2021

Abstract

Purpose

To describe the predictive value of information on previous benign biopsy for the outcome of MRI-targeted biopsies.

Methods

An exploratory analysis was conducted using data from a prospective, multicenter, paired diagnostic study of 532 men undergoing diagnostics for prostate cancer during 2016–2017. All men underwent 1.5 T MRI; systematic prostate biopsies; and MRI-targeted biopsies to MRI lesions with Prostate Imaging Reporting and Data System version 2, PI-RADS ≥ 3. The main outcome was numbers of detected prostate cancer characterized by grade group (GG) where GG ≥ 2 defined clinically significant cancer (csPCa).

Results

Men with previous biopsies had significantly more often negative MRI (26% vs. 17%, p < 0.05) compared to men without previous biopsies. Men with previous biopsies showed higher rates of benign biopsies (41% vs. 26%, p < 0.05) and lower rates of GG2 (17% vs. 30%, p < 0.05) and GG ≥ 3 (5% vs. 10%, p < 0.05) cancer. Biopsy-naïve men had higher proportions of highly suspicious MRI lesions (PIRADS 5; p < 0.05) and a higher proportion of significant cancer in those lesions (p = 0.05). In multivariate regression analysis, a previous benign prostate biopsy was associated with less than half the odds of csPCa (OR 0.38; 95% CI 0.20–0.71).

Conclusion

In this large prospective multicenter trial, we showed that men with a previous prostate biopsy had higher proportions of MRIs without lesions and lower proportion of highly suspicious lesions than biopsy-naïve men. Further, biopsy-naïve men showed higher detection of clinically significant cancer when using MRI-targeted biopsies. Also, in the era of MRI-targeted biopsy strategies, biopsy history should be carefully considered in biopsy decisions.

Trial registration

NCT02788825 (ClinicalTrials.gov). Date of registration June 2, 2016.

Available only for authorised users

Kasivisvanathan V, Rannikko AS, Borghi M et al (2018) MRI-targeted or standard biopsy for prostate-cancer diagnosis. N Engl J Med 378:1767–1777. https://doi.org/10.1056/NEJMoa1801993CrossRefPubMedPubMedCentral

Rouvière O, Puech P, Renard-Penna R et al (2019) Use of prostate systematic and targeted biopsy on the basis of multiparametric MRI in biopsy-naive patients (MRI-FIRST): a prospective, multicentre, paired diagnostic study. Lancet Oncol 20:100–109. https://doi.org/10.1016/S1470-2045(18)30569-2CrossRefPubMed

Drost F-JH, Osses DF, Nieboer D et al (2019) Prostate MRI, with or without MRI-targeted biopsy, and systematic biopsy for detecting prostate cancer. Cochrane Database Syst Rev 4:CD012663. https://doi.org/10.1002/14651858.CD012663.pub2CrossRefPubMed

Ahdoot M, Wilbur AR, Reese SE et al (2020) MRI-targeted, systematic, and combined biopsy for prostate cancer diagnosis. N Engl J Med 382:917–928. https://doi.org/10.1056/NEJMoa1910038CrossRefPubMedPubMedCentral

Mottet N, Bellmunt J, Bolla M et al (2017) EAU-ESTRO-SIOG guidelines on prostate cancer. Part 1: screening, diagnosis, and local treatment with curative intent. Eur Urol 71:618–629. https://doi.org/10.1016/j.eururo.2016.08.003CrossRefPubMed

Grönberg H, Eklund M, Picker W et al (2018) Prostate cancer diagnostics using a combination of the stockholm3 blood test and multiparametric magnetic resonance imaging. Eur Urol 74:722–728. https://doi.org/10.1016/j.eururo.2018.06.022CrossRefPubMed

Thompson IM, Ankerst DP, Chi C et al (2006) Assessing prostate cancer risk: results from the prostate cancer prevention trial. JNCI J Natl Cancer Inst 98:529–534. https://doi.org/10.1093/jnci/djj131CrossRefPubMed

Roobol MJ, van Vugt HA, Loeb S et al (2012) Prediction of prostate cancer risk: the role of prostate volume and digital rectal examination in the ERSPC risk calculators. Eur Urol 61:577–583. https://doi.org/10.1016/j.eururo.2011.11.012CrossRefPubMed

Schoots IG, Roobol MJ, Nieboer D et al (2014) magnetic resonance imaging-targeted biopsy may enhance the diagnostic accuracy of significant prostate cancer detection compared to standard transrectal ultrasound-guided biopsy: a systematic review and meta-analysis. Eur Urol 68:438–450. https://doi.org/10.1016/j.eururo.2014.11.037CrossRefPubMed

10.

Valerio M, Donaldson I, Emberton M et al (2015) Detection of clinically significant prostate cancer using magnetic resonance imaging-ultrasound fusion targeted biopsy: a systematic review. Eur Urol 68:8–19. https://doi.org/10.1016/j.eururo.2014.10.026CrossRefPubMed

11.

Baco E, Rud E, Eri LM et al (2015) A randomized controlled trial to assess and compare the outcomes of two-core prostate biopsy guided by fused magnetic resonance and transrectal ultrasound images and traditional 12-core systematic biopsy. Eur Urol. https://doi.org/10.1016/j.eururo.2015.03.041CrossRefPubMed

12.

Porpiglia F, Manfredi M, Mele F et al (2017) Diagnostic pathway with multiparametric magnetic resonance imaging versus standard pathway: results from a randomized prospective study in biopsy-naïve patients with suspected prostate cancer. Eur Urol 72:282–288. https://doi.org/10.1016/j.eururo.2016.08.041CrossRefPubMed

13.

Tonttila PP, Lantto J, Pääkkö E et al (2015) Prebiopsy multiparametric magnetic resonance imaging for prostate cancer diagnosis in biopsy-naive men with suspected prostate cancer based on elevated prostate-specific antigen values: results from a randomized prospective blinded controlled trial. Eur Urol. https://doi.org/10.1016/j.eururo.2015.05.024CrossRefPubMed

14.

Exterkate L, Wegelin O, Barentsz JO et al (2019) Is there still a need for repeated systematic biopsies in patients with previous negative biopsies in the era of magnetic resonance imaging-targeted biopsies of the prostate? Eur Urol Oncol. https://doi.org/10.1016/j.euo.2019.06.005CrossRefPubMed

15.

Radtke JP, Wiesenfarth M, Kesch C et al (2017) Combined clinical parameters and multiparametric magnetic resonance imaging for advanced risk modeling of prostate cancer-patient-tailored risk stratification can reduce unnecessary biopsies. Eur Urol 72:888–896. https://doi.org/10.1016/j.eururo.2017.03.039CrossRefPubMed

Title: Effect of information on prostate biopsy history on biopsy outcomes in the era of MRI-targeted biopsies
Authors: Anna Lantz
Erik Skaaheim Haug
Wolfgang Picker
Alessio Crippa
Fredrik Jäderling
Ashkan Mortezavi
Tobias Nordström
Publication date: 01-04-2021
Publisher: Springer Berlin Heidelberg
Keywords: Prostate Cancer
Prostate Cancer
Published in: World Journal of Urology / Issue 4/2021
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-020-03277-x

At a glance: The STEP trials

Springer Medicine

Effect of information on prostate biopsy history on biopsy outcomes in the era of MRI-targeted biopsies

Abstract

Purpose

Methods

Results

Conclusion

Trial registration

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Trial registration

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