Photo Credit: Wildpixel
A novel fully transperineal prostate fusion biopsy technique, utilizing an unconstrained ultrasound transducer, shows feasibility and comparable cancer detection rates to conventional methods, offering potential benefits in needle trajectory, hardware constraints, and patient comfort.
The following is a summary of “A Novel Magnetic Resonance Imaging/Ultrasound Fusion Prostate Biopsy Technique Using Transperineal Ultrasound: An Initial Experience,” published in the NOVEMBER 2023 issue of Urology by Enders, et al.
For a study, researchers sought to report the initial experience with a novel, “fully” transperineal (TP) prostate fusion biopsy technique, utilizing an unconstrained ultrasound transducer on the perineal skin to guide biopsy needles inserted via a TP approach.
About 76 patients with known or suspected prostate cancer underwent a total of 78 TP biopsy sessions at an academic center between June 2018 and April 2022, forming the basis of this study. These patients underwent TP prostate fusion biopsy using both transrectal ultrasound (TRUS) with a grid or freehand device and TP ultrasound in the same session. Per-session and per-lesion cancer detection rates between conventional and full TP biopsies were compared using statistical tests such as Fisher exact and McNemar’s.
Following a refinement period in 30 patients, 92 MRI-visible prostate lesions were sampled in the subsequent 46 patients, including repeat biopsies in 2 of the 30 patients from the refinement period. Grade group ≥2 cancer was diagnosed in 26% of lesions on conventional TP biopsy (17 lesions with a grid, 7 with a freehand device) and in 27% on full TP biopsy (P = 1.00). The rate of agreement for grade group ≥2 cancer between the two methods was 79% (73/92 lesions).
The study suggested that full TP biopsy, utilizing an unconstrained ultrasound transducer, is feasible and may detect prostate cancer with detection rates comparable to conventional TP biopsy. The technique offers a promising alternative with potential benefits, including improved needle trajectory, reduced hardware constraints, and enhanced patient comfort during the procedure.
Source: goldjournal.net/article/S0090-4295(23)00678-7/fulltext