{'fraction_non_alphanumeric': 0.02928416485900217, 'fraction_numerical': 0.030730296456977585, 'mean_word_length': 5.081318681318681, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
MP20-08 COMPARING THE CANCER DETECTION RATE OF MAGNETIC RESONANCE IMAGING-ULTRASOUND FUSION GUIDED VERSUS COGNITIVE-MAGNETIC RESONANCE IMAGING GUIDED PROSTATE BIOPSY FOR SMALL PROSTATE LESIONS

INTRODUCTION AND OBJECTIVE: Magnetic Resonance Imaging-Ultrasound (MRI-US) fusion technology may increase the likelihood of accurately targeting suspicious prostatic lesions seen on multiparametric MRI. The aim of our study was to assess whether prostate biopsy performed with MRI-US fusion technology has a higher cancer detection rate for small suspicious lesions seen on multiparametric MRI, compared to cognitive-MRI guided prostate biopsy. METHODS: We undertook a retrospective review of all patients that underwent a transperineal prostate biopsy for suspected prostate cancer by a group of experienced surgeons at Sydney Adventist Hospital. Records were reviewed from December 2016, following the introduction of the Koelis MRI-US fusion system, until July 2019. We compared the proportion of biopsies where cancer was detected in the Koelis fusion group to the proportion of biopsies where cancer was detected in the cognitive-MRI targeted biopsy group. MRI lesions were assigned to three size groups within the fusion and cognitive arms, those being 1) lesions 8mm or less, 2) lesions between 9 and 14mm and, 3) lesions 15mm or greater. A positive biopsy was defined as any ISUP grade group 1 or higher prostate cancer on a biopsy specimen. Categorical variables were analysed using the Chisquare test and continuous variables using the two tailed student's t-test (STATA version 15.1). RESULTS: 175 patients were included in the study, of which 86 were in the fusion group and 89 in the non-fusion group. There were 298 lesions targeted, of which 159 (53.4%) were targeted using the Koelis MRI-US fusion system. There were no differences between the fusion and cognitive groups in terms of median age, PSA and PSA density. For lesions 8mm or less, fusion targeted biopsy identified prostate cancer in 44 of 79 lesions (55.7%) compared to cognitiveMRI targeted biopsy which identified prostate cancer in 24 of 45 lesions (53.3%, c[0.65, p[0.80) For lesions between 9 and 14mm and those 15mm or greater, the fusion group had prostate cancer in 52.6% and 78.2% of lesions respectively. In the cognitive-MRI targeted biopsy group, prostate cancer was found in 58.2% of lesions measuring 9 to 14mm and in 89.7% of lesions 15mm or greater and these differences were not statistically significant. CONCLUSIONS: We found no statistically significant difference in the cancer detection rate for lesions measuring 8mm on multiparametric MRI for patients undergoing transperineal prostate biopsy using either the MRI-US fusion system (Koelis) or cognitive-MRI guided biopsy