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E.O.E Newsletter | www.huanet.gr
COMMENT ON “ACCURACY OF ELASTIC FUSION BIOPSY IN DAILY PRACTICE: RESULTS OF A MULTICENTER STUDY OF 2115 PATIENTS”
Dott. Marco Oderda
Urologist, MD, PhD, FEBU Consultant Urologist Molinette Hospital, Torino
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ΑΡΘΡΟ
In the present article we assessed the accuracy of prostate fusion biopsy performed with Koelis device (Urostation, Touch, or Trinity) across 15 European institutions. Our aim was to shed light on the detection rate of fusion biopsy in the everyday clinical practice, using an elastic fusion technology with a
targeting precision estimated at less than 3 mm on phantoms.
In the last years, a huge amount of data have been published on fusion biopsy, generally showing an improved detection rate as compared to standard biopsies. Not all fusion imaging technologies, however, are equally efficient, even if comparative data are currently lacking. The same goes for MRI quality,
which is operator dependent and is affected by case load. Our multicentric study collected data from
the everyday practice of centers that used Koelis device, taking into account that patients scheduled for biopsy could have their MRIs performed in high-volume but also low-volumes radiology units.
Our results were interesting: first, we found that the detection rate of Koelis fusion biopsy, given a positive MRI findings, was 58% for all cancers, and 43% for clinically significant
prostate cancer, confirming the superiority of fusion biopsy as
compared to standard one. Second, we evaluated the risk of harboring
prostate cancer according to the PIRADS score: prostate cancer was detected in 31% of PIRADS 3, 66% of PIRADS 4, and 89% of PIRADS 5. Multicentric MRI is not infallible, and not all PIRADS 5 correspond necessarily to prostate cancer. Third, we clearly
showed the added value of standard mapping in addition to targeted cores, corresponding to an improved detection of 13% for all cancers, and 9% for clinically significant ones.
In conclusion, this multicentric collaboration gathered the largest series of fusion biopsies reported to date, showing a good detection rate and confirming the need of a systematic sampling in addition to targeted cores.
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