Poster, Podium & Video Sessions
Presentation Authors: Sunao Shoji*, Shinichiro Hiraiwa, Takahiro Ogawa, Masanori Kawakami, Mayura Nakano, Hidenori Zakoji, Toyoaki Uchida, Takuma Tajiri, Tokyo, Japan
Introduction: To evaluate the accuracy of real-time elastic fusion image-guided transperineal prostate biopsy with needle tracking of mechanical position-encoded stepper in the detection of the significant prostate cancer for the biopsy naive men.
Methods: The patients with PSA level less than 20 ng/ml who were suspected as having prostate cancer from mpMRI scans were recruited prospectively. Target biopsies for each cancer-suspicious lesion real-time elastic fusion image-guided transperineal prostate biopsy with needle tracking of mechanical position-encoded stepper (Figure) and 12-cores systematic biopsies using the BioJet® system (D&K Technologies GmbH, Barum, Germany). Pathological findings of biopsy cores and whole mount specimen were analyzed.
Results: Two hundred fifty patients were included in the present study. Biopsy-proven significant cancer detection rate in the patients was 59% (148 of 250 patients). There was significantly different of the cancer detection rates in the patients between the target (58%, 145 of 250 patients) and systematic biopsy (34%, 86 of 250 patients) (p<0.0001). In targeted biopsy cores (n=527), biopsy-proven significant cancer detection rates (36% vs. 2.1%, p<0.0001), median positive core length (median 8mm vs. median 2mm, p<0.0001), median positive core percent (50% vs. 10%, p<0.0001), and median Gleason score (p<0.0001) were significantly higher compared with the results in systematic biopsy cores (n=3000). Biopsy-proven significant cancer detection rates of the targeted lesions with the Prostate Imaging and Reporting and Data System classification 3, 4, and 5 were 6.8%, 49%, and 80%, respectively. In whole mount specimen, the geographic locations in 96% of significant cancers were diagnosed before radical prostatectomy by both of targeted biopsy and mpMRI findings.
Conclusions: The biopsy-proven significant cancer detection rate using the present biopsy was significant higher, and the targeted biopsy cores had a significantly higher grade and larger length compared with systematic biopsies. The accuracy of geographic diagnosis of the significant cancer in the results shows the present biopsy method as a promising method.
Source Of Funding: none
Tokai University Hachioji Hospital
Sunao Shoji, MD, PhD, is a graduate of Tokyo Medical University. He trained in surgery at the St. Luke’s’ International Hospital Tokyo and urology at the Tokai University. Shoji was a research fellow of urology at University of Southern California Institute of Urology. Shoji is board certified in urology and laparoscopic surgery.Shoji received the Best poster Award at the AUA annual meeting 2013.
Specializations: minimally invasive surgery, MRI-TRUS fusion image-guided biopsy, focal therapy, high-intensity focused ultrasound, Thulium laser endoscopic surgery.