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Superior detection of significant prostate cancer by transperineal prostate biopsy using MRI-transrectal ultrasound fusion image guidance over cognitive registration

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Abstract

Background

The BioJet system allows the fusion of magnetic resonance imaging (MRI) images with real-time transrectal ultrasonography to accurately direct biopsy needles to the target lesions. To date, the superiority of targeted biopsy using the BioJet system over cognitive registration remains unknown.

Methods

This retrospective study included 171 biopsy-naïve men with elevated prostate-specific antigen (2.5–20 ng/mL) and MRI-positive lesions; 74 and 97 men underwent a four-core targeted biopsy per MRI-positive target lesion and a 14-core systematic biopsy transperineally using the BioJet system and cognitive registration, respectively. Detection rates of significant cancer, defined as grade group ≥ 2 or maximum cancer length ≥ 5 mm, were compared between the BioJet system and cognitive registration using propensity score matching and a multivariate logistic regression model.

Results

After propensity score matching (67 men for each group), the detection rates of significant cancer were significantly higher in the BioJet group than in the cognitive group for both targeted (76% vs. 46%, P = 0.002) and systematic (70% vs. 46%, P = 0.018) biopsy. Multivariate analysis of the entire cohort also showed that the BioJet system was independently associated with significant cancer detection by targeted and systematic biopsy (P < 0.01), along with a higher prostate-specific antigen density and a higher prostate imaging reporting and data system score.

Conclusions

Transperineal prostate biopsy using the BioJet system is superior to cognitive registration in detecting significant cancer for targeted and systematic biopsies.

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Acknowledgements

Figure 1c was cited with permission from the publisher of reference 14 (License number 5551200917702).

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Author notes

  1. Masaya Ito and Ichiro Yonese contributed equally to this work.

Authors and Affiliations

  1. Department of Urology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-Ku, Tokyo, 113-8677, Japan

    Masaya Ito, Ichiro Yonese, Masahiro Toide, Shuichiro Kobayashi & Fumitaka Koga

  2. Department of Radiology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan

    Shuzo Ikuta

Authors
  1. Masaya Ito
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  2. Ichiro Yonese
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  3. Masahiro Toide
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  4. Shuzo Ikuta
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  5. Shuichiro Kobayashi
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  6. Fumitaka Koga
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Contributions

Masaya Ito: Conceptualization, data curation, formal analysis, investigation, supervision, and writing–original draft preparation; Ichiro Yonese: Data curation, formal analysis, investigation, visualization, and writing–review & editing; Masahiro Toide: Investigation, writing–review & editing; Shuozo Ikuta: Investigation, writing–review & editing; Shuichiro Kobayashi: Investigation, writing–review & editing; Fumitaka Koga: Conceptualization, investigation, supervision, and writing–review & editing.

Corresponding author

Correspondence to Masaya Ito.

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Conflict of interest

The authors declare no conflicts of interest. The study protocol was approved by the Institutional Review Board (approval #2464).

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Ito, M., Yonese, I., Toide, M. et al. Superior detection of significant prostate cancer by transperineal prostate biopsy using MRI-transrectal ultrasound fusion image guidance over cognitive registration. Int J Clin Oncol 28, 1545–1553 (2023). https://doi.org/10.1007/s10147-023-02404-z

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  • DOI: https://doi.org/10.1007/s10147-023-02404-z

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