The following is a summary of “Superior detection of significant prostate cancer by transperineal prostate biopsy using MRI-transrectal ultrasound fusion image guidance over cognitive registration’’ published in the August 2023 issue of Oncology by Ito et al.
The BioJet system combines magnetic resonance imaging (MRI) and real-time transrectal ultrasonography for precise biopsy needle guidance. The effectiveness of the BioJet system for targeted biopsy is still being studied.
Researchers performed a retrospective study to compare the effectiveness of the BioJet system and cognitive registration for targeted biopsy in men with elevated prostate-specific antigen(PSA) and MRI-positive lesions.
The study included 171 biopsy-naïve men with elevated prostate-specific antigen (2.5-20 ng/mL) and MRI-positive lesions. Of these, 74 men underwent a four-core targeted biopsy per MRI-positive target lesion using the BioJet system, and 97 men underwent a 14-core systematic biopsy transperineally using cognitive registration. The comparison was carried out through propensity score matching and a multivariate logistic regression model. They compared the two methods’ significant cancer detection rates (grade group ≥ 2 or maximum cancer length ≥ 5 mm).
The prosperity score revealed (67 men in each group) that the BioJet group exhibited higher detection rates of significant cancer in both targeted (76% vs. 46%, P= 0.002) and systematic (70% vs. 46%, P= 0.018) biopsies compared to the cognitive group. The overall cohort analysis also indicated an independent association of the BioJet system with significant cancer detection in targeted and systematic biopsies (P< 0.01). This coincided with increased prostate-specific antigen density and a higher score on the prostate imaging reporting and data system.
The study found the BioJet system was better than cognitive registration for detecting significant cancer in the transperineal prostate biopsy, both for targeted and systematic biopsies.
