Clinically Significant Transition Zone Prostate Cancer Detected by UroNav MRI/TRUS Fusion Biopsy in Active Surveillance Prostate Cancer Patients

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OBJECTIVE

UroNav MRI/TRUS biopsy offers a more accurate test result regarding prostate cancer. The goal of the UroNav is to find more transitional zone prostate cancers that a standard mapping biopsy is unable to see. This paper aims to evaluate the utility of UroNav MRI/TRUS biopsy to detect clinically significant transition zone cancers in patients on active surveillance with low volume, low grade cancer.

METHODS

We retrospectively analyzed 268 prostate cancer patients from Minnesota Urology over a threeyear period who underwent a UroNav (MRI/TRUS) biopsy as part of standardized follow up in an active surveillance protocol. All patients underwent both biopsy of MRI PiRAD lesions and a standard mapping biopsy at the time of procedure. Patients with positive PiRAD transition zone and negative mapping biopsies were identified. Kaplan-Meier, Cox Proportional Hazards test, ANOVA and Chi-Square tests were performed. Data was analyzed using IBM SPSS version 27 and statistical significance was set at α=0.05.

RESULTS

Of the 268 patients, 68 (25%) of the patients had a normal standard mapping prostate biopsies. Using UroNav technology cancer was found showing a statistically significant amount of prostate cancer in the transitional zone missed by standard mapping biopsy (P value <0.05) Out of these 68 patients 35 (51.5%) were reported to have a Gleason score ≥7 indicating clinically significant prostate cancer.

CONCLUSIONS

The use of UroNav MRI/TRUS fusion biopsy allowed detection of clinically significant transition zone cancer missed by concurrent standard mapping biopsies in an active surveillance population. This should be continually explored to get a larger sample size to see if the UroNav can also detect missed clinically significant prostate cancer at a high rate.

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OBJECTIVE

UroNav MRI/TRUS biopsy offers a more accurate test result regarding prostate cancer. The goal of the UroNav is to find more transitional zone prostate cancers that a standard mapping biopsy is unable to see. This paper aims to evaluate the utility of UroNav MRI/TRUS biopsy to detect clinically significant transition zone cancers in patients on active surveillance with low volume, low grade cancer.

METHODS

We retrospectively analyzed 268 prostate cancer patients from Minnesota Urology over a threeyear period who underwent a UroNav (MRI/TRUS) biopsy as part of standardized follow up in an active surveillance protocol. All patients underwent both biopsy of MRI PiRAD lesions and a standard mapping biopsy at the time of procedure. Patients with positive PiRAD transition zone and negative mapping biopsies were identified. Kaplan-Meier, Cox Proportional Hazards test, ANOVA and Chi-Square tests were performed. Data was analyzed using IBM SPSS version 27 and statistical significance was set at α=0.05.

RESULTS

Of the 268 patients, 68 (25%) of the patients had a normal standard mapping prostate biopsies. Using UroNav technology cancer was found showing a statistically significant amount of prostate cancer in the transitional zone missed by standard mapping biopsy (P value <0.05) Out of these 68 patients 35 (51.5%) were reported to have a Gleason score ≥7 indicating clinically significant prostate cancer.

CONCLUSIONS

The use of UroNav MRI/TRUS fusion biopsy allowed detection of clinically significant transition zone cancer missed by concurrent standard mapping biopsies in an active surveillance population. This should be continually explored to get a larger sample size to see if the UroNav can also detect missed clinically significant prostate cancer at a high rate.

OBJECTIVE

UroNav MRI/TRUS biopsy offers a more accurate test result regarding prostate cancer. The goal of the UroNav is to find more transitional zone prostate cancers that a standard mapping biopsy is unable to see. This paper aims to evaluate the utility of UroNav MRI/TRUS biopsy to detect clinically significant transition zone cancers in patients on active surveillance with low volume, low grade cancer.

METHODS

We retrospectively analyzed 268 prostate cancer patients from Minnesota Urology over a threeyear period who underwent a UroNav (MRI/TRUS) biopsy as part of standardized follow up in an active surveillance protocol. All patients underwent both biopsy of MRI PiRAD lesions and a standard mapping biopsy at the time of procedure. Patients with positive PiRAD transition zone and negative mapping biopsies were identified. Kaplan-Meier, Cox Proportional Hazards test, ANOVA and Chi-Square tests were performed. Data was analyzed using IBM SPSS version 27 and statistical significance was set at α=0.05.

RESULTS

Of the 268 patients, 68 (25%) of the patients had a normal standard mapping prostate biopsies. Using UroNav technology cancer was found showing a statistically significant amount of prostate cancer in the transitional zone missed by standard mapping biopsy (P value <0.05) Out of these 68 patients 35 (51.5%) were reported to have a Gleason score ≥7 indicating clinically significant prostate cancer.

CONCLUSIONS

The use of UroNav MRI/TRUS fusion biopsy allowed detection of clinically significant transition zone cancer missed by concurrent standard mapping biopsies in an active surveillance population. This should be continually explored to get a larger sample size to see if the UroNav can also detect missed clinically significant prostate cancer at a high rate.

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Detection of Prostate Cancer in the Transitional Zone by Using a UroNav Biopsy

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Thu, 09/21/2023 - 12:46

OBJECTIVE

Transitional zone cancers are not accounted for when using standard prostate biopsy techniques. Using MRI/Transrectal ultrasound fusion biopsy (UroNav) can more accurately diagnose transitional zone prostate cancer. The goal of this study is to evaluate 375 patients with transitional zone only cancer found on a UroNav biopsy MRI/Transrectal ultrasound fusion biopsy over a three-year period to evaluate the clinical significance of their cancer.

METHOD

We retrospectively analyzed 1500 patients that underwent a UroNav biopsy over a 3 year period. 375 of these patients had transitional zone only cancers. The patients with transitional and peripheral zone cancer were analyzed. The PIRAD scores were evaluated and the percent cancer determined for each zone. Clinically significant cancer for each zone was also determined.

RESULTS

Of the 1500 patients with a PIRAD lesion, 25% were located in the transitional zone, 36% in the peripheral zone and 39% in both transitional and peripheral zone. Cancer was detected in 40% of transitional zone only lesions, 44% of peripheral zone only lesions and 38% combined zone lesion. Clinically significant cancer was noted in 26%, 27% and 20%, respectively, for the TZ, PZ and combined zones. Kaplan- Meier, Cox Proportional Hazards test, ANOVA and Chi- Square tests were performed. Data was analyzed using IBM SPSS version 27 and statistical significance was set at α=0.05. PIRAD breakdown for transitional zone only cancers are as follows, PIRAD 3 (52% of patients): 24% cancer, 10% clinically significant PIRAD 4 (34% of patients): 43% cancer, 30% clinically significant PIRAD 5 (14% of patients): 75% cancer, 60% clinically significant

CONCLUSIONS

The use of a UroNav biopsy has been instrumental in detecting clinically significant cancers in the transitional zone that otherwise would have been missed on a standard mapping biopsy.

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OBJECTIVE

Transitional zone cancers are not accounted for when using standard prostate biopsy techniques. Using MRI/Transrectal ultrasound fusion biopsy (UroNav) can more accurately diagnose transitional zone prostate cancer. The goal of this study is to evaluate 375 patients with transitional zone only cancer found on a UroNav biopsy MRI/Transrectal ultrasound fusion biopsy over a three-year period to evaluate the clinical significance of their cancer.

METHOD

We retrospectively analyzed 1500 patients that underwent a UroNav biopsy over a 3 year period. 375 of these patients had transitional zone only cancers. The patients with transitional and peripheral zone cancer were analyzed. The PIRAD scores were evaluated and the percent cancer determined for each zone. Clinically significant cancer for each zone was also determined.

RESULTS

Of the 1500 patients with a PIRAD lesion, 25% were located in the transitional zone, 36% in the peripheral zone and 39% in both transitional and peripheral zone. Cancer was detected in 40% of transitional zone only lesions, 44% of peripheral zone only lesions and 38% combined zone lesion. Clinically significant cancer was noted in 26%, 27% and 20%, respectively, for the TZ, PZ and combined zones. Kaplan- Meier, Cox Proportional Hazards test, ANOVA and Chi- Square tests were performed. Data was analyzed using IBM SPSS version 27 and statistical significance was set at α=0.05. PIRAD breakdown for transitional zone only cancers are as follows, PIRAD 3 (52% of patients): 24% cancer, 10% clinically significant PIRAD 4 (34% of patients): 43% cancer, 30% clinically significant PIRAD 5 (14% of patients): 75% cancer, 60% clinically significant

CONCLUSIONS

The use of a UroNav biopsy has been instrumental in detecting clinically significant cancers in the transitional zone that otherwise would have been missed on a standard mapping biopsy.

OBJECTIVE

Transitional zone cancers are not accounted for when using standard prostate biopsy techniques. Using MRI/Transrectal ultrasound fusion biopsy (UroNav) can more accurately diagnose transitional zone prostate cancer. The goal of this study is to evaluate 375 patients with transitional zone only cancer found on a UroNav biopsy MRI/Transrectal ultrasound fusion biopsy over a three-year period to evaluate the clinical significance of their cancer.

METHOD

We retrospectively analyzed 1500 patients that underwent a UroNav biopsy over a 3 year period. 375 of these patients had transitional zone only cancers. The patients with transitional and peripheral zone cancer were analyzed. The PIRAD scores were evaluated and the percent cancer determined for each zone. Clinically significant cancer for each zone was also determined.

RESULTS

Of the 1500 patients with a PIRAD lesion, 25% were located in the transitional zone, 36% in the peripheral zone and 39% in both transitional and peripheral zone. Cancer was detected in 40% of transitional zone only lesions, 44% of peripheral zone only lesions and 38% combined zone lesion. Clinically significant cancer was noted in 26%, 27% and 20%, respectively, for the TZ, PZ and combined zones. Kaplan- Meier, Cox Proportional Hazards test, ANOVA and Chi- Square tests were performed. Data was analyzed using IBM SPSS version 27 and statistical significance was set at α=0.05. PIRAD breakdown for transitional zone only cancers are as follows, PIRAD 3 (52% of patients): 24% cancer, 10% clinically significant PIRAD 4 (34% of patients): 43% cancer, 30% clinically significant PIRAD 5 (14% of patients): 75% cancer, 60% clinically significant

CONCLUSIONS

The use of a UroNav biopsy has been instrumental in detecting clinically significant cancers in the transitional zone that otherwise would have been missed on a standard mapping biopsy.

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