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Title: | A Diagnostic Accuracy Study of Targeted and Systematic Biopsies to Detect Clinically Significant Prostate Cancer, including a Model for the Partial Omission of Systematic Biopsies |
Author: | Morote, Juan Picola, Natàlia Muñoz Rodríguez, Jesús Paesano, Nahuel Ruiz Plazas, Xavier Muñoz Rivero, Marta V. Celma, Anna García de Manuel, Gemma Aisian, Ignacio Servian, Pol Abascal, José M. |
Keywords: | Càncer de pròstata Biòpsia Prostate cancer Biopsy |
Issue Date: | 13-Sep-2023 |
Publisher: | MDPI AG |
Abstract: | The primary objective of this study was to analyse the current accuracy of targeted and systematic prostate biopsies in detecting csPCa. A secondary objective was to determine whether there are factors predicting the finding of csPCa in targeted biopsies and, if so, to explore the utility of a predictive model for csPCa detection only in targeted biopsies. We analysed 2122 men with suspected PCa, serum PSA > 3 ng/mL, and/or a suspicious digital rectal examination (DRE), who underwent targeted and systematic biopsies between 2021 and 2022. CsPCa (grade group 2 or higher) was detected in 1026 men (48.4%). Discrepancies in csPCa detection in targeted and systematic biopsies were observed in 49.6%, with 13.9% of csPCa cases being detected only in systematic biopsies and 35.7% only in targeted biopsies. A predictive model for csPCa detection only in targeted biopsies was developed from the independent predictors age (years), prostate volume (mL), PI-RADS score (3 to 5), mpMRI Tesla (1.5 vs. 3.0), TRUS-MRI fusion image technique (cognitive vs. software), and prostate biopsy route (transrectal vs. transperineal). The csPCa discrimination ability of targeted biopsies showed an AUC of 0.741 (95% CI 0.721-0.762). The avoidance rate of systematic prostate biopsies went from 0.5% without missing csPCa to 18.3% missing 4.6% of csPCa cases. We conclude that the csPCa diagnostic accuracy of targeted biopsies is higher than that of systematic biopsies. However, a significant rate of csPCa remains detected only in systematic biopsies. A predictive model for the partial omission of systematic biopsies was developed. |
Note: | Reproducció del document publicat a: https://doi.org/10.3390/cancers15184543 |
It is part of: | Cancers, 2023, vol. 15, num. 18 |
URI: | http://hdl.handle.net/2445/209248 |
Related resource: | https://doi.org/10.3390/cancers15184543 |
ISSN: | 2072-6694 |
Appears in Collections: | Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL)) |
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