AUA 2019: Targeted Versus Systemic Biopsy for Diagnosing Prostate Cancer
Posted: Friday, May 17, 2019
Although multiparametric magnetic resonance imaging (MRI) with targeted biopsy is often used in the detection of prostate cancer, the results of the Prostate Active Surveillance Study (PASS) suggest that systemic biopsy cannot be omitted based on the results of a negative or positive MRI. The study was presented at the 2019 American Urological Association (AUA) Annual Meeting in Chicago (Abstract PD50-01).
Michael Liss, MD, of the University of Texas Health, San Antonio, and colleagues evaluated 351 MRIs from 325 patients who underwent a biopsy within 12 months of an MRI. They found that the negative predictive value of MRI when detecting a Gleason grade prostate cancer of 2 or higher was 76%, indicating that the probability of not having a Gleason grade ≥2 cancer based on negative MRI results was just 76%. In addition to a 49% false-positive rate, Dr. Liss and colleagues suggested that the widescale applicability of MRI results is limited.
In a sensitivity analysis of 287 MRIs from 270 men with Gleason grade 1 cancer prior to imaging, biopsy reclassification to Gleason grade 2 was observed in 21% of men with a negative MRI and 35% of men with a positive MRI. In 192 fusion biopsies, Gleason grade agreement between the target and systematic biopsies was 81%. Targeted biopsies identified a higher Gleason grade than systematic biopsy in 8% of men, whereas systematic biopsy identified a higher Gleason grade than targeted in 11%.
Disclosure: The study authors’ disclosure information may be found at auajournals.org.
