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@ARTICLE{Tschirdewahn:157143,
author = {S. Tschirdewahn and M. Wiesenfarth$^*$ and D. Bonekamp$^*$
and L. Püllen and H. Reis and A. Panic and C. Kesch and C.
Darr and J. Heß and F. Giganti and C. M. Moore and N.
Guberina and M. Forsting and A. Wetter and B. Hadaschik and
J. P. Radtke$^*$},
title = {{D}etection of {S}ignificant {P}rostate {C}ancer {U}sing
{T}arget {S}aturation in {T}ransperineal {M}agnetic
{R}esonance {I}maging/{T}ransrectal {U}ltrasonography-fusion
{B}iopsy.},
journal = {European urology focus},
volume = {7},
number = {6},
issn = {2405-4569},
address = {Amsterdam},
publisher = {Elsevier},
reportid = {DKFZ-2020-01429},
pages = {1300-1307},
year = {2021},
note = {2021 Nov;7(6):1300-1307},
abstract = {Multiparametric magnetic resonance imaging (mpMRI) and
targeted biopsies (TBs) facilitate accurate detection of
significant prostate cancer (sPC). However, it remains
unclear how many cores should be applied per target.To
assess sPC detection rates of two different target-dependent
magnetic resonance imaging (MRI)/transrectal ultrasonography
(TRUS)-fusion biopsy approaches (TB and target saturation
[TS]) compared with extended systematic biopsies
(SBs).Retrospective single-centre outcome of transperineal
MRI/TRUS-fusion biopsies of 213 men was evaluated. All men
underwent TB with a median of four cores per MRI lesion,
followed by a median of 24 SBs, performed by experienced
urologists. Cancer and sPC (International Society of
Urological Pathology grade group ≥2) detection rates were
analysed. TB was compared with SB and TS, with nine cores
per target, calculated by the Ginsburg scheme and using
individual cores of the lesion and its 'penumbra'.Cancer
detection rates were calculated for TS, TB, and SB at both
lesion and patient level. Combination of SB + TB served as a
reference. Statistical differences in prostate cancer (PC)
detection between groups were calculated using McNemar's
tests with confidence intervals.TS detected $99\%$ of 134
sPC lesions, which was significantly higher than the
detection by TB $(87\%,$ p = 0.001) and SB $(82\%,$ p <
0.001). SB detected significantly more of the 72 low-risk PC
lesions than TB $(99\%$ vs $68\%,$ p < 0.001) and $10\%$ (p
= 0.15) more than that detected by TS. At a per-patient
level, $99\%$ of men harbouring sPC were detected by TS.
This was significantly higher than that by TB and SB
$(89\%,$ p = 0.03 and $81\%,$ p = 0.001, respectively).
Limitations include limited generalisability, as a
transperineal biopsy route was used.TS detected
significantly more cases of sPC than TB and extended SB.
Given that both $99\%$ of sPC lesions and men harbouring sPC
were identified by TS, the results suggest that this
approach allows to omit SB cores without compromising sPC
detection.Target saturation of magnetic resonance
imaging-suspicious prostate lesions provides excellent
cancer detection and finds fewer low-risk tumours than the
current gold standard combination of targeted and systematic
biopsies.},
cin = {C060 / E010},
ddc = {610},
cid = {I:(DE-He78)C060-20160331 / I:(DE-He78)E010-20160331},
pnm = {315 - Bildgebung und Radioonkologie (POF4-315)},
pid = {G:(DE-HGF)POF4-315},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:32660838},
doi = {10.1016/j.euf.2020.06.020},
url = {https://inrepo02.dkfz.de/record/157143},
}