#0776

Accuracy of Targeted Transrectal Ultrasound Prostate Biopsies

B. Razi¹, H. Gibbs¹, D. Cole-Clark¹, D. Self¹, M. Louie-Johnsun¹

¹Gosford Hospital, Gosford, Australia

Introduction:

With the widespread adoption of multiparametric MRI (mpMRI) for investigation of suspected prostate cancer, targeted biopsy specimens are more common practice than previously held. The PRECISION trial demonstrated a reduced detection of insignificant cancer whilst increasing the detection of significant cancers when patients only with positive MRIs were biopsied. Whilst the PROMIS study demonstrated 11% of normal MRI, had biopsy confirmed prostate cancer. This study aims to investigate the accuracy and sensitivity of targeted trans-rectal ultrasound (TRUS) prostate biopsies when correlated with MRI.

Material and methods:

A prospective database was maintained for the cohort of patients who underwent TRUS procedures with prior mpMRI by a single surgeon. The MRI findings were compared to the subsequent histopathological results from the targeted biopsies.

Results:

A total of 91 men were included in the study, with a mean age of 67 years and mean PSA of 9.2 ng/ml. 75% had Prostate Imaging and Reporting Data System (PI-RADS) 4-5 lesions 24% had PI-RADS 3 lesions. Clinically significant prostate cancer was identified in 73% target biopsies. 12% had ISUP 5, 10% ISUP 4, 10% ISUP 3 and 41% ISUP 2 disease. 27% of targeted biopsies had a ‘negative’ result, either no malignancy or clinically insignificant (ISUP 1) disease. An ISUP grade of higher significance was identified outside of the target biopsy in 14% patients. The upstaging from a negative targeted biopsy to significant cancer was identified in 8% patients. Targeted TRUS biopsy had a sensitivity of 92% and a negative predictive value of 71%