Spatial distribution of biopsy cores and the detection of intra-lesion pathologic heterogeneity.

Authors

• Brian P Calio
• Sandeep Deshmukh
• Donald Mitchell
• Christopher G Roth
• Anne E Calvaresi
• Kim Hookim
• Peter McCue
• Edouard J Trabulsi
• Costas D Lallas

Publication/Presentation Date

1-1-2019

Abstract

OBJECTIVES: The objective of this study was to determine if spatial distribution of multiparametric magnetic resonance imaging-transrectal ultrasound (mpMRI-TRUS) fusion biopsy cores to the index lesion reveals trends in the detection of intra-lesion Gleason heterogeneity and a more optimal prostate biopsy strategy.

METHODS: Index lesion was the lesion with longest diameter on T2-weighted (T2W)-MRI. In cohort 1, fusion biopsy cores biopsies were taken in areas in the center of the target as well as 1 cm laterally on each side. For cohort 2, targeted biopsies were taken from the center of the lesion only. Heterogeneity was defined as difference in maximum Gleason score obtained from fusion cores in the center of the index lesion

RESULTS: Ninety-nine consecutive patients (35 and 64 in cohorts 1 and 2, respectively) with median age (SD) and prostate-specific antigen (PSA) of 66.9 (±5.9) and 9.7 (±8.2) respectively, were included. Age, PSA, Prostate Imaging Reporting and Data System (PI-RADS) score, and preoperative MRI lesion size were not significantly different between cohorts. Gleason heterogeneity was observed at a significantly higher rate in cohort 1

CONCLUSIONS: We demonstrate that there is observable tumor heterogeneity in biopsy specimens, and that increased number of cores, as well as cores focused on the center and periphery of the largest lesion in the prostate, provide more comprehensive diagnostic information about the patient's clinical risk category than taking nonspecific cores targeted within the tumor.

Volume

11

First Page

1756287219842485

Last Page

1756287219842485

ISSN

1756-2872

Published In/Presented At

Calio, B. P., Deshmukh, S., Mitchell, D., Roth, C. G., Calvaresi, A. E., Hookim, K., McCue, P., Trabulsi, E. J., & Lallas, C. D. (2019). Spatial distribution of biopsy cores and the detection of intra-lesion pathologic heterogeneity. Therapeutic advances in urology, 11, 1756287219842485. https://doi.org/10.1177/1756287219842485

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

31065294

Department(s)

Administration and Leadership

Document Type

Article