The following is a summary of “A Novel Biopsy Scheme for Prostate Cancer: Targeted and Regional Systematic Biopsy,” published in the April 2024 issue of Urology by He et al.
In this study, the researchers investigated a novel biopsy scheme for prostate cancer (PCa) and evaluated its detection rate and pathological agreement compared to standard systematic (SB) + targeted (TB) biopsy. Positive needles from 194 patients who underwent SB + TB (STB) followed by radical prostatectomy (RP) were collected. Our novel biopsy scheme, targeted and regional systematic biopsy (TrSB), consisted of TB combined with regional SB (4 SB needles closest to the TB needles).
The McNemar test was employed to compare the detection rate performance for clinically significant PCa (csPCa) and clinically insignificant PCa (ciPCa), along with investigating accuracy, positive predictive value (PPV), and negative predictive value (NPV). The agreement between the different biopsy scheme grade groups (GG) and RP GG was assessed, and concordance between biopsy and RP GG was evaluated using weighted κ coefficient analyses. The overall detection rate for csPCa combined with SB and TB was 83.5%. TrSB demonstrated superior NPV compared to TB alone (97.0% vs. 74.4%). Additionally, unlike TB alone, TrSB exhibited no significant difference in csPCa detection rate compared to STB. For ciPCa, the overall detection rate was 16.5%, with TrSB demonstrating better PPV and NPV than TB alone.
Interestingly, the pathological agreement between the three biopsy schemes (TB/TrSB/STB) GG and RP GG showed no difference. In conclusion, our novel biopsy scheme TrSB may reduce the number of biopsy cores compared to STB while demonstrating comparable csPCa detection rates. Moreover, TrSB showed improved NPV compared to TB alone. Overall, the pathological agreement between TrSB and the other biopsy schemes and RP GG was consistent, suggesting its potential as an effective approach in PCa diagnosis.
Source: bmcurol.biomedcentral.com/articles/10.1186/s12894-024-01461-4