UCL Discovery
UCL home » Library Services » Electronic resources » UCL Discovery

Comparison of Transrectal Ultrasound Biopsy to Transperineal Template Mapping Biopsies Stratified by Multiparametric Magnetic Resonance Imaging Score in the PROMIS Trial

Lovegrove, C; Miah, S; El-Shater Bosaily, A; Bott, S; Brown, L; Burns-Cox, N; Dudderidge, T; ... Ahmed, HU; + view all (2020) Comparison of Transrectal Ultrasound Biopsy to Transperineal Template Mapping Biopsies Stratified by Multiparametric Magnetic Resonance Imaging Score in the PROMIS Trial. The Journal of Urology , 203 (1) pp. 100-107. 10.1097/JU.0000000000000455. Green open access

[thumbnail of JU.0000000000000455.pdf]
Preview
Text
JU.0000000000000455.pdf - Accepted version

Download (1MB) | Preview

Abstract

Introduction: We evaluated performance of transrectal ultrasound-guided systematic (TRUS) biopsy compared to transperineal template mapping (TPM) with a 5mm sampling frame, stratified by MP-MRI Likert score within the PROMIS study. / Methods: Biopsy-naïve men due prostate biopsy for elevated PSA and/or abnormal digital rectal examination underwent MP-MRI, TPM and TRUS biopsies, conducted and reported blind to other test results. Clinically significant prostate cancer (csPCa) was primarily defined as Gleason >/=4+3 or maximum cancer core length (MCCL) >/=6mm of any grade, and secondarily Gleason >/=3+4 or MCCL >/=4mm of any grade. / Results: In 41 months, 740 men at 11 centres were recruited; 576 underwent all three tests. Of 150 with MRI score 1-2, 8 (5.1%) had any Gleason >/=3+4 disease on TRUS-biopsy. In 75 where TRUS-biopsy showed Gleason 3+3 of any MCCL, 61/75 (81%) had Gleason 3+4, 8/75 (11%) Gleason 4+3 and 0/75 (0%) Gleason >/=4+5. For definition1 csPCa, TRUS-biopsy sensitivity remained stable and low across MP-MRI Likert scores (35%-52%). For definition2 csPCa and any cancer, sensitivity increased with higher MP-MRI score. Negative predictive value varied due to varying disease prevalence but for all cancer thresholds declined with increasing MP-MRI score. / Conclusions: TRUS-biopsy in the setting of MP-MRI Likert scores 1-2 finds Gleason 3+4 disease in only 1 in 20 men. Further, for any csPCa definition, TRUS-biopsy had poor sensitivity and variable but low NPV across MP-MRI scores. Men undergoing TRUS-biopsy without targeting in the setting of MP-MRI score 3 to 5 should be advised to undergo a repeat (targeted) biopsy.

Type: Article
Title: Comparison of Transrectal Ultrasound Biopsy to Transperineal Template Mapping Biopsies Stratified by Multiparametric Magnetic Resonance Imaging Score in the PROMIS Trial
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1097/JU.0000000000000455
Publisher version: https://doi.org/10.1097/JU.0000000000000455
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: MRI, biopsy, prostate, template, transrectal
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Department of Imaging
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci > Department of Targeted Intervention
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology > MRC Clinical Trials Unit at UCL
URI: https://discovery.ucl.ac.uk/id/eprint/10078998
Downloads since deposit
74Downloads
Download activity - last month
Download activity - last 12 months
Downloads by country - last 12 months

Archive Staff Only

View Item View Item