The Korean Journal of Urological Oncology (대한비뇨기종양학회지)

Korean Urological Oncology Society (대한비뇨기종양학회)
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Initial Experience of Transperineal Biopsy After Multiparametric Magnetic Resonance Imaging in Korea; Comparison With Transrectal Biopsy

  • Yoon, Sung Goo (Department of Urology, Korea University School of Medicine) ;
  • Jin, Hyun Jung (Department of Urology, Korea University School of Medicine) ;
  • Tae, Jong Hyun (Department of Urology, Korea University School of Medicine) ;
  • No, Tae Il (Department of Urology, Korea University School of Medicine) ;
  • Kim, Jae Yoon (Department of Urology, Korea University School of Medicine) ;
  • Pyun, Jong Hyun (Department of Urology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Shim, Ji Sung (Department of Urology, Korea University School of Medicine) ;
  • Kang, Sung Gu (Department of Urology, Korea University School of Medicine) ;
  • Cheon, Jun (Department of Urology, Korea University School of Medicine) ;
  • Lee, Jeong Gu (Department of Urology, Korea University School of Medicine) ;
  • Kim, Je Jong (Department of Urology, Korea University School of Medicine) ;
  • Sung, Deuk Jae (Department of Urology, Korea University School of Medicine) ;
  • Lee, Kwan Hyi (Department of Biomedical Engineering, University of Science and Technology) ;
  • Kang, Seok Ho (Department of Urology, Korea University School of Medicine)
  • Received : 2018.09.10
  • Accepted : 2018.09.27
  • Published : 2018.12.30
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Abstract

Purpose: The aim of this study is to confirm the detection rate of transperineal biopsy after multiparametric magnetic resonance imaging (mpMRI) and compared it to that of transrectal biopsy. We also examined the role of mpMRI and the rate of complications for each method. Materials and Methods: In a retrospective study, we analyzed 147 patients who underwent mpMRI before prostate biopsy because of elevated serum prostate-specific antigen and/or abnormal digital rectal examination findings at Korea University Hospital, Seoul, Korea from March 2017 to April 2018. Regions on the mpMRI that were suggestive of prostate cancer were categorized according to the Prostate Imaging-Reporting and Data System (PI-RADS v2). For transperineal biopsy, a 20-core saturation biopsy was performed by MRI-TRUS cognitive or fusion techniques and a 12-core biopsy was performed in transrectal biopsy. Results: Sixty-three and 84 patients were enrolled in transperineal group and transrectal group, respectively. The overall detection rate of prostate cancer in transperineal group was 27% higher than that in transrectal group. Classification according to PI-RADS score revealed a significant increase in detection rate in all patients, as the PI-RADS score increased. Frequency of complications using the Clavien-Dindo classifications revealed no significant differences in the total complications rate, but two patients in transrectal group received intensive care unit care due to urosepsis. Conclusions: Our results confirmed that transperineal biopsy is superior to transrectal biopsy for the detection of prostate cancer. From the complication point of view, this study confirmed that there were fewer severe complications in transperineal biopsy.

Keywords

Acknowledgement

Supported by : Korea University College of Medicine

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