Freehand transperineal biopsy sampling strategies: what is the optimal template?

You have accessJournal of UrologyProstate Cancer: Detection & Screening IV (MP43)1 Sep 2021MP43-05 FREEHAND TRANSPERINEAL BIOPSY SAMPLING STRATEGIES: WHAT IS THE OPTIMAL TEMPLATE? Ajith Dupati, Ji Qi, John M. DiBianco, Stephanie Ferrante, Adam Cole, Adam Walker, John T. Wei, Chandy Ellimoottil, Lindsey A. Herrel, Richard C. Wu, Brian R. Stork, and Arvin K. George Ajith DupatiAjith Dupati More articles by this author , Ji QiJi Qi More articles by this author , John M. DiBiancoJohn M. DiBianco More articles by this author , Stephanie FerranteStephanie Ferrante More articles by this author , Adam ColeAdam Cole More articles by this author , Adam WalkerAdam Walker More articles by this author , John T. WeiJohn T. Wei More articles by this author , Chandy EllimoottilChandy Ellimoottil More articles by this author , Lindsey A. HerrelLindsey A. Herrel More articles by this author , Richard C. WuRichard C. Wu More articles by this author , Brian R. StorkBrian R. Stork More articles by this author , and Arvin K. GeorgeArvin K. George More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002064.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Multiple transperineal prostate (TP) biopsy templates exist but with uncertainty regarding the optimal sampling strategy. Prior work shows that anterior base cores from the transition zone have minimal diagnostic yield. Thus, we aimed to compare the cancer detection rate (CDR) between the 12-core modified Barzell (MB) template with a novel Michigan Urological Surgery Improvement Collaborative (MUSIC) TP biopsy template created to increase peripheral zone sampling where cancer detection is greatest. METHODS: All patients undergoing freehand TP biopsy from June 2017 to November 2020 were included. The MB template was used from June 2017 to January 2019 and modified to develop the MUSIC TP template which was performed from January 2019 onwards. Patient demographic, clinical, and pathological variables were collected. Bivariate and multivariable logistic regression model was performed to compare CDR between MB and MUSIC TP biopsy templates. RESULTS: A total of 283 biopsies were included utilizing the MB (n=139) and MUSIC template (n=144). Overall CDR of the MB and MUSIC TP templates were 38.1% and 47.2%, respectively (p=0.122). CDR of ≥Gleason Grade group (GG) 2 for the MB and MUSIC TP templates were 21.6% and 25%, respectively, (p=0.497). Controlling for age, race, PSA, digital rectal exam, urologist, prior diagnosis and family history of prostate cancer, no significant difference between the templates in overall CDR (OR=1.11, CI 0.61-2.04, p=0.73) or ≥GG2 CDR (OR=1.15, CI 0.68-1.94, p=0.59) was observed. A subset of MUSIC TP biopsies (n=103) that had 1-2 additional midline core(s) obtained (apex, base) were identified. The addition of the midline cores only resulted in a single GG1 diagnosis and no cases of higher risk disease not identified with the standard MUSIC template. CONCLUSIONS: There is no significant difference in CDR between the MB and MUSIC TP biopsy templates. The addition of midline peripheral zone cores to the MUSIC TP template does not improve cancer diagnosis and should not be routinely included in sampling. Continued evaluation with greater power may demonstrate a significant difference in CDR between sampling strategies. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e783-e783 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ajith Dupati More articles by this author Ji Qi More articles by this author John M. DiBianco More articles by this author Stephanie Ferrante More articles by this author Adam Cole More articles by this author Adam Walker More articles by this author John T. Wei More articles by this author Chandy Ellimoottil More articles by this author Lindsey A. Herrel More articles by this author Richard C. Wu More articles by this author Brian R. Stork More articles by this author Arvin K. George More articles by this author Expand All Advertisement Loading ...