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Can systematic biopsy be safely avoided at the time of magnetic resonance imaging/ultrasonography fusion biopsy?

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In clinical practice, the need for maximising prostate cancer detection is often balanced against the theoretical risks of infection, bleeding, and pain associated with taking additional cores. In this novel… Click to show full abstract

In clinical practice, the need for maximising prostate cancer detection is often balanced against the theoretical risks of infection, bleeding, and pain associated with taking additional cores. In this novel study, Sathianathen et al. [1] provide a tool for measuring the oncological benefit of including concurrent systematic biopsy (SB) at the time of MRI-guided targeted biopsy (TB). There were several key findings: (i) Amongst patients undergoing MRI-guided biopsy (all biopsy settings), 11.6% were found to have significant cancers detected by SB alone; (ii) Amongst patients who had clinically significant cancers detected by SB alone, 52.2% were sampled within sextants outside the targeted regions of interest; (iii) According to the proposed nomogram, patients with prior negative biopsies, fewer MRI lesions, and lower Prostate Imaging-Reporting and Data System (PI-RADS) scores were at the lowest risk of missing significant cancer when SB was omitted.

Keywords: biopsy; systematic biopsy; avoided time; safely avoided; biopsy safely

Journal Title: BJU International
Year Published: 2019

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