Prostate biopsies using magnetic resonance imaging (MRI) fusion are more likely than those using transrectal ultrasound (TRUS) to yield findings concordant with final pathology results at the time of radical prostatectomy, investigators reported at the 20th annual meeting of the Society of Urologic Oncology in Washington, DC.
Using the Pennsylvania Urologic Regional Collaborative (PURC) database, Ruchika Talwar, MD, of the University of Pennsylvania Perelman School of Medicine in Philadelphia, and colleagues studied 1437 patients who underwent either traditional TRUS (1247 patients) or MRI fusion biopsies (196 patients) biopsies followed by radical prostatectomy (RP). The overall upgrading rate for patients with Grade Group (GG) 1 was high for both biopsy techniques but the rate at final pathology was significantly lower for MRI fusion than TRUS biopsy (81.5% vs 91%).
On average, the exact concordance rate between biopsy and final pathology was significantly higher for MRI fusion than TRUS biopsy (44.4% vs 35.3%), Dr Talwar and her colleagues reported. The overall rate of upgrading on final pathology for MRI fusion biopsies was lower than for TRUS biopsies, but the difference was not significant. The investigators found no significant difference in upgrading rates for GG 2 or GG 3 disease.
“This data provides relevant information with which to counsel our patients when considering the various biopsy techniques, especially when considering active surveillance versus definitive treatment,” the investigators concluded in their study abstract.
With regard to the racial composition of the study population, 54.6% identified as white, 20.2% identified as black, 5.4% identified as other, and 20% had no race recorded. Of the 1437 patients, 35.8%, 28.5%, 13.3%, 11.5% had 10.9% had GG 1, 2, 3, 4, and 5 cancer, respectively.
Talwar R, Michel K, Malhotra A, et al. Concordance rates between MRI fusion versus TRUS prostate biopsy and pathology at radical prostatectomy: Data from the PURC. Presented at the 20th annual meeting of the Society of Urologic Oncology held December 4 to 6 in Washington, DC. Poster 96.