Man vs. Machine: Comparing Cognitive and Software-Assisted mpMRI-Ultrasound Fusion Targeted Biopsy
BAUS ePoster online library. Khoo C. Jun 24, 2019; 259549; P5-5
Mr. Christopher Khoo
Mr. Christopher Khoo
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Abstract
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INTRODUCTION

The clinical utility of software-assisted mpMRI-US fusion targeted biopsy is currently controversial considering capital investment. We compared the rates of prostate cancer detection using cognitive versus software-assisted image-fusion targeted biopsy.

Patients and Methods
Analysis of our prostate cancer diagnostics registry identified men who had undergone cognitive or image-fusion targeted biopsy for a PI-RADS v2 score of ≥3. Diagnostic rates of clinically significant prostate cancer (any Gleason ≥3+4), insignificant disease and benign histology were calculated for each approach and differences compared for statistical significance. Potential confounders were also evaluated.

RESULTS

Between April 2017 and October 2018, 142 patients were biopsied cognitively and 194 with image-fusion software (Biopsee®). Baseline demographics were similar (table 1) with overall mean targeted cores of 6.9 for cognitive and 5.9 for image-fusion biopsies. Clinically significant prostate cancer was found in 48.6% and 54.6% for cognitive and image-fusion approaches respectively (p>0.05). Insignificant cancer was detected in 11.3% and 11.9% (p>0.05) and benign histology in 40.1% and 33.5% (p>0.05) respectively (table 2).

CONCLUSION

We found no statistically significant differences in overall cancer detection rates. There may have been clinically relevant differences in number of cores taken and clinically significant cancer detection both overall and by mpMRI PI-RADS v2 score. A prospective appropriately powered randomised trial that overcomes residual confounders is planned.
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