title: Diagnostic Accuracy of Robot-Guided, Software Based Transperineal MRI/TRUS Fusion Biopsy of the Prostate in a High Risk Population of Previously Biopsy Negative Men.
abstract: Objective. In this study, we compared prostate cancer detection rates between MRI-TRUS fusion targeted and systematic biopsies using a robot-guided, software based transperineal approach.Methods and Patients. 52 patients received a MRIT/TRUS fusion followed by a systematic volume adapted biopsy using the same robot-guided transperineal approach. The primary outcome was the detection rate of clinically significant disease (Gleason grade ≥ 4). Secondary outcomes were detection rate of all cancers, sampling efficiency and utility, and serious adverse event rate. Patients received no antibiotic prophylaxis.Results. From 52 patients, 519 targeted biopsies from 135 lesions and 1561 random biopsies were generated (totaln= 2080). Overall detection rate of clinically significant PCa was 44.2% (23/52) and 50.0% (26/52) for target and random biopsy, respectively. Sampling efficiency as the median number of cores needed to detect clinically significant prostate cancer was 9 for target (IQR: 6-14.0) and 32 (IQR: 24-32) for random biopsy. The utility as the number of additionally detected clinically significant PCa cases by either strategy was 0% (0/52) for target and 3.9% (2/52) for random biopsy.Conclusions. MRI/TRUS fusion based target biopsy did not show an advantage in the overall detection rate of clinically significant prostate cancer.
authors.affiliation: Department of Urology, Medical Center, Faculty of Medicine, University of Freiburg, Hugstetter Strasse 55, 79106 Freiburg, Germany.
authors.forename: Malte
authors.identifier: 0000-0003-0787-992X
authors.initials: M
authors.lastname: Kroenig
authors.affiliation: Department of Urology, Medical Center, Faculty of Medicine, University of Freiburg, Hugstetter Strasse 55, 79106 Freiburg, Germany.
authors.forename: Kathrin
authors.initials: K
authors.lastname: Schaal
authors.affiliation: Department of Radiology, Medical Center, Faculty of Medicine, University of Freiburg, Hugstetter Strasse 55, 79106 Freiburg, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Benndorf
authors.affiliation: Department of Radiology, Medical Center, Faculty of Medicine, University of Freiburg, Hugstetter Strasse 55, 79106 Freiburg, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Soschynski
authors.affiliation: Department of Radiology, Medical Center, Faculty of Medicine, University of Freiburg, Hugstetter Strasse 55, 79106 Freiburg, Germany.
authors.forename: Philipp
authors.initials: P
authors.lastname: Lenz
authors.affiliation: Department of Radiology, Medical Center, Faculty of Medicine, University of Freiburg, Hugstetter Strasse 55, 79106 Freiburg, Germany.
authors.forename: Tobias
authors.initials: T
authors.lastname: Krauss
authors.affiliation: Department of Clinical Pathology, Medical Center, Faculty of Medicine, University of Freiburg, Breisacher Strasse 115a, 79106 Freiburg, Germany.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Drendel
authors.affiliation: Department of Clinical Pathology, Medical Center, Faculty of Medicine, University of Freiburg, Breisacher Strasse 115a, 79106 Freiburg, Germany.
authors.forename: Gian
authors.identifier: 0000-0002-0587-9742
authors.initials: G
authors.lastname: Kayser
authors.affiliation: Department of Clinical Pathology, Medical Center, Faculty of Medicine, University of Freiburg, Breisacher Strasse 115a, 79106 Freiburg, Germany.
authors.forename: Philipp
authors.initials: P
authors.lastname: Kurz
authors.affiliation: Department of Clinical Pathology, Medical Center, Faculty of Medicine, University of Freiburg, Breisacher Strasse 115a, 79106 Freiburg, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Werner
authors.affiliation: Department of Urology, Medical Center, Faculty of Medicine, University of Freiburg, Hugstetter Strasse 55, 79106 Freiburg, Germany.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Wetterauer
authors.affiliation: Department of Urology, Medical Center, Faculty of Medicine, University of Freiburg, Hugstetter Strasse 55, 79106 Freiburg, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Schultze-Seemann
authors.affiliation: Department of Radiology, Medical Center, Faculty of Medicine, University of Freiburg, Hugstetter Strasse 55, 79106 Freiburg, Germany.
authors.forename: Mathias
authors.initials: M
authors.lastname: Langer
authors.affiliation: Department of Urology, Medical Center, Faculty of Medicine, University of Freiburg, Hugstetter Strasse 55, 79106 Freiburg, Germany.
authors.forename: Cordula A
authors.initials: CA
authors.lastname: Jilg
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000737:chemistry; D005189:False Positive Reactions; D006801:Humans; D061705:Image-Guided Biopsy / Q000379:methods*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000473:pathology* / Q000601:surgery; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012371:Robotics; D012984:Software
chemical_list: D000900:Anti-Bacterial Agents; D017430:Prostate-Specific Antigen