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The value of magnetic resonance imaging and ultrasonography (MRI/US)-fusion biopsy in clinically significant prostate cancer detection in patients with biopsy-naïve men according to PSA levels: Apropensity score matching analysis

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Author(s)
Hye J. ByunTeak J. ShinWonho JungJi Y. HaByung H. KimYoung H. Kim
Keimyung Author(s)
Byun, Hye JinShin, Teak JunJung, Won HoHa, Ji YongKim, Byung Hoon
Department
Dept. of Urology (비뇨의학)
Journal Title
Prostate Int
Issued Date
2022
Volume
10
Issue
1
Keyword
Magnetic resonance imagingProstate cancerProstate-specific antigen
Abstract
Objectives:
To evaluate the detection rate of clinically significant prostate cancer (csPCa) in Magnetic resonance imaging and ultrasonography (MRI/US) fusion biopsy in patients with biopsy-naïve men for varying prostate-specific antigen (PSA) levels. Since MRI can efficiently detect csPCa compared to standard transrectal ultrasound (TRUS) guided biopsy; however, the optimal PSA threshold for its use is unclear.

Materials and methods:
We retrospectively reviewed those who underwent MRI/US-fusion and standard biopsy from January 2016 to June 2018. Patients were divided into three groups: PSA <4, 4–10, >10 ng/mL. Propensity scoring was performed to balance the characteristics of the different biopsy groups, and the detection rate of csPCa was compared.

Results:
Data from a total of 670 males were included in the analysis (standard TRUS, n = 333; MRI/US fusion, n = 337). Prior to matching, patients who received MRI/US-fusion biopsy had lower prostate volume. Propensity score matching balanced this characteristic and generated a cohort comprising 195 patients from each group. In the matched cohort, patients with PSA 4–10 ng/mL had a significantly increased risk of csPCa by MRI/US-fusion vs. standard biopsy (35.0% vs. 26.6%, P = 0.033). However, patients with PSA <4 ng/mL had csPCa found by MRI/US-fusion versus standard biopsy (12.0% vs. 16.0%, P = 0.342), whereas, patients with PSA >10 ng/mL had csPCa found by MRI/US-fusion versus standard biopsy (78.0% vs. 80.0%, P = 0.596). In multivariate logistic analysis among patients with PSA 4-10 ng/mL, MRI/US-fusion biopsy (odds ratio: 2.46, 95% confidence interval = 1.31–4.60, P = 0.005) were significantly associated with a detection of csPCa.

Conclusions:
Detection of csPCa by MRI/US-fusion biopsy is more efficient in patients with biopsy-naïve men with PSA 4–10 ng/mL. However, standard TRUS biopsy may identify csPCa in patients with PSA <4 ng/mL and ≥10 ng/mL, emphasizing the importance of performing a standard biopsy in conjunction with MRI/US-fusion biopsy in such populations.
Keimyung Author(s)(Kor)
변혜진
신택준
정원호
하지용
김병훈
Publisher
School of Medicine (의과대학)
Citation
Hye J. Byun et al. (2022). The value of magnetic resonance imaging and ultrasonography (MRI/US)-fusion biopsy in clinically significant prostate cancer detection in patients with biopsy-naïve men according to PSA levels: Apropensity score matching analysis. Prostate Int, 10(1), 45–49. doi: 10.1016/j.prnil.2021.10.002
Type
Article
ISSN
2287-8882
Source
https://www.sciencedirect.com/science/article/pii/S2287888221000568
DOI
10.1016/j.prnil.2021.10.002
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/44286
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Urology (비뇨의학)
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