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Cognitive fusion-targeted biopsy versus transrectal ultrasonography-guided systematic biopsy: comparison and analysis of the risk of Gleason score upgrading

  • Urology - Original Paper
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Abstract

Purpose

The aim of this study is to assess the precision of the Gleason score (GS) obtained through cognitive fusion-targeted biopsy (COG-TB) in comparison to transrectal ultrasonography-guided systematic biopsy (TRUS-SB), and to identify factors that can predict Gleason score upgrading (GSU) in a cohort of Chinese patients.

Methods

A final enrollment of 245 patients was recorded. Between 2020 and 2022, 132 patients underwent TRUS-SB, and 113 patients underwent COG-TB. The Chi-square test was performed to analyze the variation in downgrading, concordance, and upgrading between TRUS-SB and COG-TB. Multivariable analyses were performed to seek factors predicting Gleason score upgrading. Finally, a model which utilizes multivariable logistic regression was developed to predict the likelihood of GSU.

Results

The concordance for TRUS-SB and COG-TB were 42.4% and 65.5%, respectively. TRUS-SB and COG-TB exhibited notable disparities in downgrading, concordance, and upgrading. Age, prostate volume, body mass index (BMI), and the biopsy modality were significant predictive factors.

Conclusion

COG-TB can significantly increase concordance with final histopathology. Age, prostate volume, BMI, and the biopsy modality were predictive factors of GSU.

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Data availability

The corresponding authors can provide the necessary data for this study upon reasonable request.

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Funding

No financial support was given for this research.

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Authors and Affiliations

  1. Department of Urology, Qilu Hospital of Shandong University, Jinan, 250012, Shandong, China

    Tianyun Zheng, Kaipeng Bi, Yueqing Tang, Yuan Zeng, Junyan Wang & Lei Yan

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  1. Tianyun Zheng
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  2. Kaipeng Bi
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  3. Yueqing Tang
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  4. Yuan Zeng
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  5. Junyan Wang
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  6. Lei Yan
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Contributions

TYZ curated the entire project and wrote the article. KPB analyzed the data and produced figures. YQT contributed to project development and writing. YZ and JW collected relevant clinical data. LY supervised the conduct of the study from start to finish and review the article.

Corresponding author

Correspondence to Lei Yan.

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All procedures performed in studies involving human participants were in accordance with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

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Zheng, T., Bi, K., Tang, Y. et al. Cognitive fusion-targeted biopsy versus transrectal ultrasonography-guided systematic biopsy: comparison and analysis of the risk of Gleason score upgrading. Int Urol Nephrol 56, 981–988 (2024). https://doi.org/10.1007/s11255-023-03848-y

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