Comparing Biopsy Methods in Detecting Prostate Cancer
Posted: Wednesday, July 17, 2019
For men undergoing first-time prostate biopsies, magnetic resonance imaging (MRI)-visible lesions can identify those with a heightened risk of clinically significant prostate cancer; however, combining targeted and systematic biopsies increases the chance of detecting the disease. Leonard Marks, MD, of the University of California Los Angeles (UCLA), and colleagues published their findings from the PAIREDCAP trial in JAMA Surgery.
“To maximize our ability to identify prostate cancer, we need to take advantage of all the information we can,” said Dr. Marks in a UCLA press release. “Our cancer detection rate, while using different methods in tandem, surpasses that from using either method alone. In this case, one plus one equals three.”
The team designed a paired cohort trial that enrolled men undergoing first-time prostate biopsy from 2015 to 2018. Participants included a series of men with MRI-visible lesions who underwent three biopsy methods at the same time (systematic, MRI-lesion targeted by cognitive fusion, and MRI-lesion targeted by software fusion) as well as a series of men without MRI-visible lesions who underwent systematic biopsies alone. Of the 300 participants, 248 had MRI-visible lesions.
The rate of cancer detection was 15% utilizing systematic sampling in the group without MRI-visible lesions. The cancer detection rate for cognitive fusion biopsy alone was 47%, compared with 60% when using systematic biopsy or either fusion method alone. This cancer detection rate rose to 70% when systematic and targeted methods were combined, providing the greatest sensitivity for detection of clinically significant prostate cancer.
“Men being assessed for prostate cancer should first receive an MRI before biopsy,” noted Dr. Marks in a UCLA press release. “When there’s a lesion on MRI, physicians should take systematic and targeted biopsies together for the best chance at finding cancer.”
Disclosure: The study authors’ disclosure information may be found at jamanetwork.com.
