Cognitive Versus Software Fusion for MRI-targeted Biopsy: Experience Before and After Implementation of Fusion

摘要

ObjectiveTo compare the diagnostic performance of the 2 most common approaches of magnetic resonance imaging targeted biopsy (TB)—cognitive registration targeted biopsy (COG-TB) and software fusion targeted biopsy (FUS-TB)—we assessed our institutional experience with both methods. TB has emerged to complement systematic template biopsy (SB) in prostate cancer (PCa) diagnosis; however, which magnetic resonance imaging targeting methodology is diagnostically better remains unclear. Materials and methodsA total of 510 patients underwent TB at our institution before and after the adoption of fusion software with the UroNav platform (Invivo Corporation, Gainsville, FL). All patients had concurrent 12-core SB. We compared rates of clinically significant PCa detection, and rates of upstaging and missed diagnosis in reference to SB among patients who received COG-TB and patients who received FUS-TB. We also compared both COG-TB and FUS-TB results to their paired SB results. ResultsThe rates of upstaging or missing clinically significant PCa with FUS-TB (in reference to SB) was not significantly different from COG-TB (P?=?0.172), nor was the risk of missing clinically significant PCa different between FUS-TB vs COG-TB on logistic regression ( Odds ratio?=?0.55,P?=?0.106). No significant difference in biopsy outcomes was observed between FUS-TB and COG-TB (P?=?0.171). We did find significant differences between FUS-TB and SB and between COG-TB and SB, with SB finding more clinically insignificant PCa (P?