The predictive role of MRI cognitive biopsy for gleason score on radical prostatectomy material

Year 2024, Volume: 41 Issue: 1, 138 - 142, 29.03.2024

Süleyman Öner , Yakup Bostancı , Murat Gülşen , Ender Özden , Yarkin Yakupoglu , Şaban Sarıkaya

Abstract

The diagnostic efficiency of systematic biopsy, which is currently accepted as the standard in primary care, is limited in the diagnosis of prostate cancer (PCa). If the compatibility between prostate biopsy specimens and radical prostatectomy (RP) specimens is better, it is likely that the oncological and functional outcomes of the patients will also improve. In this study, patients who underwent systematic + cognitive or only systematic biopsy after multi-parametric magnetic resonance imaging (mpMRI) with the suspicion of PCa in our clinic and patients who underwent RP with the diagnosis of local / locally advanced PCa as a result of biopsy were examined retrospectively. It was aimed to compare the Gleason score concordance between the biopsy specimens and the RP specimens of the patients.73 patients who underwent RP between November 2015 and November 2017 were included in the study. Four patients who received chemotherapy before RP were excluded from the study. While MRI cognitive + systematic biopsy was performed in 38 patients, only systematic biopsy was performed in 31 patients. In the last stage, histopathological results of MRI cognitive + systematic biopsy, only systematic biopsy and RP specimens were compared retrospectively. When compared according to RP results, Gleason score was decreased in 5 (13.2%) of 38 patients who underwent MRI cognitive + systematic biopsy, did not change in 22 patients (57.9%) and was increased in 11 (28.9%) patients. Of the 31 patients who underwent only systematic biopsy, Gleason score decreased in 2 patients (6.5%), remained unchanged in 10 patients (32.3%), and increased in 19 patients (61.3%). Statistically significant difference was found between those who underwent MRI cognitive + systematic biopsy and those who only underwent systematic biopsy in terms Gleason score concordance according to the RP result (p=0.026). Gleason grade of tumors after RP can be more accurately predicted with MRI cognitive + systematic biopsy. Thus, surgical success may increase (necessity of lymph node dissection, etc.). For this reason, we think that MRI cognitive + systematic biopsy should be performed in patients with suspected PCa.

Keywords

prostate cancer, prostate biopsy, MRI cognitive prostate biopsy, gleason score

Ethical Statement

Approval was obtained from Ondokuz Mayıs University Clinical Researc Ethics committee, the study started. The ethics committee decision date is 30/11/2017 and the number of ethical committee decision is 2017/405.

References

• Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA: A Cancer Journal for Clinicians. 2011;61(2):69-90.
• Bjurlin MA, Mendhiratta N, Wysock JS, Taneja SS. Multiparametric MRG and targeted prostate biopsy: Improvements in cancer detection, localization, and risk assessment. Central European Journal of Urology. 2016;69(1):9.
• Bjurlin MA, Meng X, Le Nobin J, Wysock JS, Lepor H, Rosenkrantz AB, et al. Optimization of prostate biopsy: the role of magnetic resonance imaging targeted biopsy in detection, localization and risk assessment. The Journal of Urology. 2014;192(3):648-58.
• Moore CM, Robertson NL, Arsanious N, Middleton T, Villers A, Klotz L, et al. Image-guided prostate biopsy using magnetic resonance imaging–derived targets: a systematic review. European Urology. 2013;63(1):125-40.
• Cornud F, Roumiguié M, Barry de Longchamps N, Ploussard G, Bruguière E, Portalez D, et al. Precision Matters in MR Imaging–targeted Prostate Biopsies: Evidence from a Prospective Study of Cognitive and Elastic Fusion Registration Transrectal Biopsies. Radiology. 2018;287(2):534-42.
• Mottet N, Bellmunt J, Bolla M, Briers E, Cumberbatch MG, De Santis M, et al. EAU-ESTRO-SIOG guidelines on prostate cancer. Part 1: screening, diagnosis, and local treatment with curative intent. European Urology. 2017;71(4):618-29.
• Ploussard G, Beauval J-B, Lesourd M, Almeras C, Assoun J, Aziza R, et al. Added value of concomitant systematic and fusion targeted biopsies for grade group prediction based on radical prostatectomy final pathology on positive magnetic resonance imaging. The Journal of Urology. 2019;202(6):1182-7.
• Ploussard G, Borgmann H, Briganti A, De Visschere P, Fütterer JJ, Gandaglia G, et al. Positive pre-biopsy MRG: are systematic biopsies still useful in addition to targeted biopsies? World Journal of Urology. 2019;37(2):243-51.
• Marliere F, Puech P, Benkirane A, Villers A, Lemaitre L, Leroy X, et al. The role of MRG-targeted and confirmatory biopsies for cancer upstaging at selection in patients considered for active surveillance for clinically low-risk prostate cancer. World Journal of Urology. 2014;32(4):951-8.
• Rouvière O, Puech P, Renard-Penna R, Claudon M, Roy C, Mège-Lechevallier F, et al. Use of prostate systematic and targeted biopsy on the basis of multiparametric MRG in biopsy-naive patients (MRG-FIRST): a prospective, multicentre, paired diagnostic study. The Lancet Oncology. 2019;20(1):100-9.
• Ficarra V, Novara G, Ahlering TE, Costello A, Eastham JA, Graefen M, et al. Systematic review and meta-analysis of studies reporting potency rates after robot-assisted radical prostatectomy. European Urology. 2012;62(3):418-30.
• Kasivisvanathan V, Rannikko AS, Borghi M, Panebianco V, Mynderse LA, Vaarala MH, et al. MRG-targeted or standard biopsy for prostate-cancer diagnosis. New England Journal of Medicine. 2018;378(19):1767-77.
• Porpiglia F, De Luca S, Passera R, Manfredi M, Mele F, Bollito E, et al. Multiparametric-magnetic resonance/ultrasound fusion targeted prostate biopsy improves agreement between biopsy and radical prostatectomy Gleason score. Anticancer Research. 2016;36(9):4833-9.
• Lanz C, Cornud F, Beuvon F. Gleason score determination with TRUS-MRG fusion guided prostate biopsies: are we gaining in accuracy. J Urol. 2016;195(1):88-93.
• Borkowetz A, Platzek I, Toma M, Renner T, Herout R, Baunacke M, et al. Direct comparison of multiparametric magnetic resonance imaging (MRG) results with final histopathology in patients with proven prostate cancer in MRG/ultrasonography‐fusion biopsy. BJU international. 2016;118(2):213-20.
• Diamand R, Oderda M, Al Hajj Obeid W, Albisinni S, Van Velthoven R, Fasolis G, et al. A multicentric study on accurate grading of prostate cancer with systematic and MRG/US fusion targeted biopsies: comparison with final histopathology after radical prostatectomy. World Journal of Urology. 2019;37(10):2109-17.
• Puech P, Rouvière O, Renard-Penna R, Villers A, Devos P, Colombel M, et al. Prostate cancer diagnosis: multiparametric MR-targeted biopsy with cognitive and transrectal US–MR fusion guidance versus systematic biopsy—prospective multicenter study. Radiology. 2013;268(2):461-9.
• Wysock JS, Rosenkrantz AB, Huang WC, Stifelman MD, Lepor H, Deng F-M, et al. A prospective, blinded comparison of magnetic resonance (MR) imaging–ultrasound fusion and visual estimation in the performance of MR-targeted prostate biopsy: the PROFUS trial. European Urology. 2014;66(2):343-51.
• Ryan J, Broe MP, Moran D, Mulvin D, Heffernan E, Swan N, et al. Prostate cancer detection with magnetic resonance imaging (MRG)/cognitive fusion biopsy: Comparing standard and targeted prostate biopsy with final prostatectomy histology. Canadian Urological Association Journal. 2021;15(9): E483.