Site Overlay

Fusion Biopsy of the Prostate –A New Dimension in Diagnostics

By Борис Попщерев

Volume 12, Issue 1

Original Article / Published: December 2024

DOI:

Tzvetkov N, Krastev K, Stoyanov N, Ibrahimov K, Davidov K

Clinic of Urology, University Hospital Sofiamed

Abstract

Purpose. Prostate cancer remains a major global health concern, ranking as the second most common malignancy among men and the third leading cause of cancer-related mortality. This study evaluates the diagnostic advantages of MRI-ultrasound fusion-guided prostate biopsy compared to traditional systematic biopsy techniques.
Methods. A comprehensive meta-analysis was conducted, including 15 clinical studies with 5,337 cases. Patients were divided into two groups: 2,667 underwent MRI-ultrasound fusion-guided biopsy, and 2,670 underwent standard systematic biopsy. Data from databases such as PubMed, Medline, and Web of Science were analyzed to compare biopsy success rates.
Results. Fusion-guided biopsy demonstrated a significantly higher detection rate of clinically significant prostate cancer (Gleason score ≥7) compared to standard systematic biopsy (OR=1.37, 95% CI 1.19-1.58, P<0.05). For low-risk cancers (Gleason score <7), systematic biopsy showed better results (OR=0.76, 95% CI 0.65-0.89, P<0.05). Fusion-guided biopsy also exhibited superior sensitivity for lesions in atypical zones, such as the anterior and transitional regions.
Conclusion. MRI-ultrasound fusion-guided prostate biopsy enhances diagnostic accuracy, particularly for clinically significant prostate cancers, and minimizes the risk of under-diagnosis. However, its accessibility and cost remain challenges for widespread implementation

References

  1. Wang L, Lu B, He M, Wang Y, Wang Z, Du L. Prostate Cancer Incidence and Mortality: Global Status and Temporal Trends in 89 Countries From 2000 to 2019. Front Public Health. 2022 Feb 16;10:811044. doi: 10.3389/fpubh.2022.811044. PMID: 35252092; PMCID: PMC8888523.
  2. Serdar M A, Oguz O, Olgun A et al. Diagnostic approach to prostate cancer using total prostate-specific antigen-based parameters together. Ann Clin Lab Sci. 2002;32(01):22–30.
  3. Sfoungaristos S, Perimenis P. Evaluating PSA density as a predictor of biochemical failure after radical prostatectomy: results of a prospective study after a median follow-up of 36 months. ISRN Urol. 2013;2013:984951.
  4. The comparison of fusion targeting biopsy and systematic biopsy in the clinical diagnosis of prostate cancer: a meta-analysis – https://pubmed.ncbi.nlm.nih.gov/28606276/ L J Zhang 1, B Wu, Z L Zha, H Zhao, W Yang, X H Chen, B Jiang, Y F Jiang, J L Yin
  5. An update on prostate biopsy in the era of magnetic resonance imaging – https://pubmed.ncbi.nlm.nih. gov/29595039/ Antonio Cicione 1, Cosimo De Nunzio 2, Stefano Manno 3, Rocco Damiano 3, Alessandro Posti 4, Estevao Lima 5, Andrea Tubaro 2, Filippo Balloni.
  6. (Lu M, Luo Y, Wang Y, Yu J, Zheng H, Yang Z. Transrectal versus transperineal prostate biopsy in the detection of prostate cancer: a retrospective study based on 452 patients. BMC Urol. 2023 Jan 28;23(1):11. doi: 10.1186/s12894-023-01176-y. PMID: 36709292; PMCID: PMC9883893.)
  7. ( Wei C, Szewczyk-Bieda M, Bates AS, et al. Multicenter Randomized Trial Assessing MRI and Image-guided Biopsy for Suspected Prostate Cancer: The MULTIPROS Study. Radiology. 2023;308(1):e221428. doi: 10.1148/radiol.221428).
  8. Chang DT, Challacombe B, Lawrentschuk N. Transperineal biopsy of the prostate—is this the future? Nat Rev Urol. 2013;10(12):690–702. doi: 10.1038/nrurol.2013.195. [PubMed] [CrossRef] [Google Scholar] [Ref list]) (8. Pradere B, Veeratterapillay R, Dimitropoulos K, Yuan Y, Omar MI, MacLennan S, et al. Nonantibiotic strategies for the prevention of infectious complications following prostate biopsy: a systematic review and meta-analysis. JUrol. 2021;205(3):653– 663. doi: 10.1097/JU.0000000000001399. [PubMed] [CrossRef] [Google Scholar] [Ref list])
Volume 11, Issue 1
Article [pdf]

Keywords:

Prostate cancer, MRI ultrasound fusion biopsy, diagnostic accuracy, Gleason score, minimally invasive diagnostics

How to cite this article:

Tzvetkov N, Krastev K, Stoyanov N, Ibrahimov K, Davidov K En-bloc vs. Three-Lobe: The Relevant Approach in Modern Holmium Laser Enucleation?; Endourology and minimally invasive surgery, 2024; 12(1): 38-41

Corresponding author:

Dr. Nikola Tzvetkov,

Clinic of Urology Sofiamed University Hospital

Address: 16A G.M. Dimitrov Blvd. Sofia 1000, Bulgaria

Email: nikolatzvetkov96@gmail