To assess the most efficient biopsy method to improve International Society of Urological Pathology (ISUP) grade group accuracy with final pathology of the radical prostatectomy (RP) specimen in the era of magnetic resonance imaging (MRI)-driven pathway.
A total of 753 patients diagnosed by transrectal MRI-targeted and systematic biopsies (namely "standard method"), treated by RP, between 2016 and 2021 were evaluated. Biopsy methods included MRI-targeted biopsy, side-specific systematic biopsies relative to index MRI lesion and combination of both. Number of MRI-targeted biopsy cores and positive cores needed per index MRI lesion were assessed. Multivariable analysis was performed to analyze predictive factors of upgrading using MRI targeted and ipsilateral systematic biopsies method.
Overall, ISUP grade group accuracy varied among biopsy methods with upgrading rate of 35%, 49%, 27%, and 24% for MRI targeted, systematic, MRI targeted and ipsilateral systematic biopsies and standard methods, respectively (p < 0.001). A minimum of two positive MRI-targeted biopsies cores per index MRI lesion were required when testing MRI targeted and ipsilateral systematic biopsies method to reach equivalent accuracy compared to standard method. Omitting contralateral systematic biopsies spared an average of 5.9 cores per patient. At multivariable analysis, only the number of positive MRI-targeted biopsy cores per index MRI lesion was predictive of upgrading.
MRI targeted and ipsilateral systematic biopsies allowed an accurate definition of ISUP grade group and appears to be an interesting alternative when compared with standard method, reducing total number of biopsy cores needed.
World journal of urology. 2022 Dec 12 [Epub ahead of print]
Romain Diamand, Alexandre Peltier, Jean-Baptiste Roche, Elena Lievore, Vito Lacetera, Giuseppe Chiacchio, Valerio Beatrici, Riccardo Mastroianni, Giuseppe Simone, Olivier Windisch, Daniel Benamran, Alexandre Fourcade, Truong An Nguyen, Georges Fournier, Gaelle Fiard, Guillaume Ploussard, Thierry Roumeguère, Simone Albisinni
Department of Urology, Jules Bordet Institute-Erasme Hospital, Hôpital Universitaire de Bruxelles, Université Libre de Bruxelles, Rue Meylemeersch 90, 1070, Brussels, Belgium. ., Department of Urology, Jules Bordet Institute-Erasme Hospital, Hôpital Universitaire de Bruxelles, Université Libre de Bruxelles, Rue Meylemeersch 90, 1070, Brussels, Belgium., Department of Urology, Clinique Saint-Augustin, Bordeaux, France., Department of Urology, Azienda Ospedaliera Ospedali Riuniti Marche Nord, Pesaro, Italy., Department of Urology, IRCCS "Regina Elena" National Cancer Institute, Rome, Italy., Department of Urology, Hôpitaux Universitaires de Genève, Geneva, Switzerland., Department of Urology, Hôpital Cavale Blanche, CHRU Brest, Brest, France., Department of Urology, Grenoble Alpes University Hospital, Université Grenoble Alpes, CNRS, Grenoble INP, TIMC, Grenoble, France., Department of Urology, La Croix du Sud Hospital, Quint Fonsegrives, France.
PubMed http://www.ncbi.nlm.nih.gov/pubmed/36509932