|ECR 2018 / C-1573|
|Prostate random biopsy versus targeted biopsy|
Aims and objectives
The aim of our study was the retrospective evaluation of 70 Random Prostate Biopsies (RPB). 13/70 biopsies were performed with Target Fusion Imaging (TFI). The assessment of the different results between the two proceduress in percentage of positivity was also obtained. TFI with a minimum number of samples in terms of positivity is able to prove the same effectiveness of RPB if the biopsy procedure is anticipated by a multiparametric-Magnetic Resonance Imaging (mp-MRI) that allows the building of a prostatic lesions "mapping" with the option of choosing the most suspicious target for biopsy.
The current algorithm of the clinically suspected prostate malignancy diagnosis is based upon the Trans-Rectal Ultrasound (TRUS) RPB procedure with a number of cores ranging from 12 to 50 (so-called saturation biopsy) which is not free of complications they may arise in proportion to the number of taken withdrawals.
Various lab parameters are currently screened (PSA Ratio, PSA Density, PSA Velocity, Dosage of Pro-PSA); all of these lab values are useful but none is proved to show full reliability.
Since the PSA value has proved to be sensitive but not a specific diagnostic parameter for malignancy, prostate TRUS has also shown some limits for cancer detection considering that only 20% of the hypoechoic prostatic lesions are proven to be malignant.
The management of patients with variable PSA value, however, is not easy and very often the decision of the correct timing of the TRUS core biopsy is equivocal in particular when a PSA value rise does not match a Digital Rectal Examination (DRE) result.
The Gold Standard for the diagnosis and staging of the Prostatic Cancer (PC) is represented by the (mp-MRI) that, thanks to the integration of the anatomical and functional sequences (T2W-TSE, DWI and DCE), is able to achieve a high sensitivity (81%) and specificity (84%) rate.
Recently, thanks to TFI, the lesions highlighted by the mp-MRI scanning can be sampled by means of a targeted procedure.
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