Delaying transperineal fusion biopsies of the prostate for up to 8 months in men with suspicious lesions detected by multiparametric magnetic resonance imaging (mpMRI) has no effect on biopsy findings, according to a new study.

“In the current COVID-19 crisis, selectively delaying image-guided prostate biopsies is unlikely to result in a higher rate of significant cancer,” Ziv Savin, MD, of Tel-Aviv Sourasky Medical Center in Israel, and colleagues concluded in a paper published in Urologic Oncology.

The investigators evaluated the association between biopsy delay time and outcomes among 195 men with a median age of 68 years. The median delay between mpMRI and transperineal biopsy was 5 months, and 90% of patients had a delay of 8 months or less.


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Biopsy delay time was 3 months or less for 59 patients (early biopsy group) and more than 3 months for 136 patients (late biopsy group). A higher rate of biopsy-naive patients underwent early biopsies compared with late biopsies (51% vs 30%, respectively, P =.009). The investigators observed no significant differences between the groups in the proportion of men found to have clinically significant cancer (grade group 2 or higher) or any cancer.

Men who underwent early biopsies had a significantly higher rate of PI-RADS 5 lesions (32% vs 13%, P =.007). When delay time was evaluated as a continuous variable, PI-RADS 5 lesions were associated with shorter biopsy delay times and previous biopsies were associated with longer delay times, according to the investigators.

“Our findings suggest that under current practice, where men with PI-RADS 5 lesions and no previous biopsies undergo earlier evaluation, a delay of up to 8 months between imaging and biopsy does not affect biopsy findings,” the authors concluded.

Reference

Savin Z, Dekalo S, Marom R, et al. The effect of delaying transperineal fusion biopsy of the prostate for patients with suspicious MRI findings—Implications for the COVID-19 era. Urol Oncol. Published online August 7, 2020. doi:10.1016/j.urolonc.2020.07.009