To report an initial experience with a novel, "fully" transperineal prostate fusion biopsy using an unconstrained ultrasound transducer placed on the perineal skin to guide biopsy needles inserted via a transperineal approach.
Conventional transperineal prostate biopsies for detection of prostate cancer have been performed with transrectal ultrasound, requiring specialized hardware, imposing limitations on needle trajectory, and contributing to patient discomfort. Seventy-six patients with known or suspected prostate cancer underwent 78 transperineal biopsy sessions in an academic center between June 2018 and April 2022 and were included in this study. These patients underwent transperineal prostate fusion biopsy using a grid or freehand device with transrectal ultrasound as well as transperineal prostate fusion biopsy using transperineal ultrasound in the same session. Per-session and per-lesion cancer detection rates were compared for conventional and fully transperineal biopsies using Fisher's exact and McNemar's tests.
After a refinement period in 30 patients, 92 MRI-visible prostate lesions were sampled in 46 subsequent patients, along with repeat biopsies in two of the 30 patients from the refinement period. Grade group ≥ 2 cancer was diagnosed in 24/92 lesions (26%) on conventional transperineal biopsy (17 lesions with grid, 7 with freehand device), and in 25/92 lesions (27%) on fully transperineal biopsy (p = 1.00), with a 73/92 (79%) rate of agreement for grade group ≥ 2 cancer between the two methods.
Fully transperineal biopsy is feasible and may detect prostate cancer with detection rates comparable to conventional transperineal biopsy.
Urology. 2023 Aug 10 [Epub ahead of print]
Jacob J Enders, Peter A Pinto, Sheng Xu, Patrick Gomella, Michael B Rothberg, Jibriel Noun, Zoe Blake, Michael Danesvhar, Reza Seifabadi, Daniel Nemirovsky, Lindsey Hazen, Charisse Garcia, Ming Li, Sandeep Gurram, Peter L Choyke, Maria J Merino, Antoun Toubaji, Baris Turkbey, Nicole Varble, Bradford J Wood
Center for Interventional Oncology, National Institutes of Health, Bethesda, Maryland, USA; Urologic Oncology Branch, National Cancer Institute, National Institute of Health, Bethesda, Maryland, USA., Urologic Oncology Branch, National Cancer Institute, National Institute of Health, Bethesda, Maryland, USA., Center for Interventional Oncology, National Institutes of Health, Bethesda, Maryland, USA., Molecular Imaging Branch, National Cancer Institute, National Institutes of Health Bethesda, Maryland, USA., Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA., Center for Interventional Oncology, National Institutes of Health, Bethesda, Maryland, USA; Philips Research North America, Cambridge, Massachusetts, USA., Center for Interventional Oncology, National Institutes of Health, Bethesda, Maryland, USA; Urologic Oncology Branch, National Cancer Institute, National Institute of Health, Bethesda, Maryland, USA; National Institute of Biomedical Imaging and Bioengineering, Bethesda, MD, USA. Electronic address: .