Targeted prostate biopsy devices include a 3-dimensional digital template grid for guiding systematic biopsy locations. Following a template could better ensure uniform and well-distributed sampling of the prostate compared to the traditional free-hand biopsy approach, possibly decreasing the chance for false-negative biopsy. Thus, we determined cancer detection rates obtained by conventional free-hand systematic sampling versus template mapping sampling using an MRI/ultrasound fusion device.

Men who underwent first-time conventional or image-guided prostate biopsy were identified retrospectively in an IRB-approved protocol. Excluded were men with prior biopsy or treatment, or fewer than 10 cores taken. Targeted cores taken from image-guided biopsy were censored from analysis to simulate systematic template biopsy. The resulting cancer detection rate was compared to that of conventional biopsies.

We identified 1582 patients who met criteria for analysis between 2006 and 2014: 1052 patients who underwent conventional biopsy and 530 who underwent template biopsy with an MRI/Ultrasound fusion device. Age, PSA, and number of systematic cores were the same in both groups. Template biopsy detected any prostate cancer in 257/530 men (48.5%) and clinically-significant cancer in 196/530 (37.0%), whereas conventional biopsy detected any cancer in 432/1052 (41.0%, p=0.005) and clinically-significant cancer in 308/1052 (29.2%, p=0.002).

Template mapping systematic biopsy detects more prostate cancer than conventional sampling in biopsy-naïve men, and is a promising cost-effective alternative to MRI/Ultrasound biopsy as an upfront screening tool.

The Journal of urology. 2019 Oct 09 [Epub ahead of print]

Steve R Zhou, Edward Chang, Aalhad Patankar, Jiaoti Huang, Leonard S Marks, Shyam Natarajan

David Geffen School of Medicine, University of California, Los Angeles., Department of Urology, University of Washington., Department of Bioengineering, University of California, Los Angeles., Department of Pathology, Duke University., Department of Urology, University of California, Los Angeles.