Keywords:
Oncology, Urinary Tract / Bladder, MR, Ultrasound, Biopsy, Cancer
Authors:
S. J. Pattiarachchi, W. Thambavitage, M. Lozinskiy, Y. Yuminaga, Y. Weerakkody; Perth, WA/AU
DOI:
10.26044/ranzcr2021/R-0469
Methods and materials
In our institution, we undertake transperineal freehand ultrasound-guided biopsies for those with suspected prostate cancer. Almost all of these patients tend to have an MRI scan prior to the procedure.
A retrospective analysis of 98 such transperineal free-hand prostate biopsies performed over a time period from January 2020 to November 2020 at Royal Perth Hospital was carried out.
The mean age of patients was 67 with an age range of 45 to 88 years.
All patients had initial diagnostic MR imaging and then underwent subsequent ultrasound-guided prostate biopsies.
- 78 (79.5%) of patients had a lesion greater than PI-RADS 3. They then underwent sampling specifically at or adjacent (i.e. within one clock face) to targeted sites with additional systematic samples to non-targeted sites also performed elsewhere within the prostate .
- 20 (20.4%) of patients did not have a target lesion on MRI and underwent systematic sampling.
A minimum of 11 core biopsies were obtained in each case whilst those with specific lesions on a preceding MRI having upto 16 cores (with extra-cores primarily being through the region of the targeted lesion/lesions).
Position of lesions on imaging vs histological correlation was then analysed in accordance with the clock-face location of respective lesions within the prostate. When the initial MRI had revealed a positive (suspicious) lesion, all patients had cognitive targeted biopsies of the suspected location as well as a few additional systematic samples elsewhere in the prostate.
The percentage of Gleason 6 or above results from tissue samples corresponding to the MRI detected lesion site, as well as that of samples outside this region, was then analysed.