A Prospective Study on the Efficacy of Cognitive Targeted Transrectal Ultrasound Prostate Biopsy in Diagnosing Clinically Significant Prostate Cancer

Figures & data

Table 1 Patients Demographic Data

Parameters	Numbers/Mean/Percentage
Total Number of patients (n)	75
Mean age ± SD (years)	66.31 ± 7.9
Patients with abnormal DRE (n)	26 (34.6%)
Median serum PSA/IQR (ng/mL)	10.6 (4.5–20)
Median prostate volume/SD (cc)	45.67 ± 18.9
Total number of MRI suspicious lesions (n)	163
Comorbidities (n)
Diabetes (n)	29
Hypertension (n)	28
Coronary artery disease (n)	11
Chronic kidney disease (n)	4
Nil (n)	27

Table 2 Core Wise Comparison of Standard Biopsy versus Cognitive Targeted Biopsy Using mpMRI Data in Detecting Prostate Cancer

Variables	mpMRI CTB	Standard Biopsy	P-value
Total cores (n)	326	1263	≤0.01
Positive core (n)	120	371
Yield in Percentage (%)	36.80	29.35

Note: n – number of cores.

Table 3 Patient Wise Comparison of Standard Biopsy versus Cognitive Targeted Biopsy Using mpMRI Data in Detecting Prostate Cancer

Variables	mpMRI CTB +ve	mpMRI CTB -ve	Total (n)
Standard biopsy +ve (n)	31	9	40
Standard biopsy -ve (n)	3	32	35
Total (n)	34	41	75

Note: n – number of patients.

Table 4 Analysis of PIRADS Score and Detection of Clinically Significant Cancer

PIRADS Score (N=75)	No. of Patients Diagnosed with Cancer in SB	No. of Patients Diagnosed with Cancer in mpMRI CTB	Percentage of Patients with Cancer Detection (%)	No. of Patients with Gleason’s Score ≥7(4+3)	No. of Patients with Gleason’s Score <7
3 (n=42)	23	17	59.52 (n=25)	22/25(88%)	3/25(12%)
4 (n=23)	11	12	52.17 (n=13)	12/13(92.30%)	1/23(7.70%)
5 (n=10)	6	5	70 (n=7)	7/7 (100%)	0/7 (0%)

Table 5 Patient Wise Comparisons of SB versus Combined Biopsy (Standard + CTB) Using mpMRI Data in Detecting Prostate Cancer

Variables	Combined Biopsy +ve	Combined Biopsy -ve	Total
Standard biopsy +ve (n)	40	0	40
Standard biopsy -ve (n)	3	32	35
Total (n)	43	32	75
p-value	≤ 0.0001^#

Notes: n – number of patients. ^#Combined biopsy had significantly higher cancer detection rate. Kappa statistics = 0.92 (agreement between two methods is 92%), 95% CI (0.75–0.93).

Abbreviation: CI, confidence interval.

Table 6 Patient Wise Comparisons of mpMRI CTB versus Combined Biopsy (Standard + CTB) in Detecting Prostate Cancer

Variables	Combined Biopsy +ve	Combined Biopsy -ve	Total
mpMRI CTB +ve(n)	34	0	34
mpMRI CTB -ve (n)	9	32	41
Total (n)	43	32	75
p-value	≤ 0.0001^#

Notes: n – number of patients. ^#Combined biopsy had significantly higher cancer detection rate. Kappa statistics = 0.76 (agreement between two methods is 76%), 95% CI (0.58–0.76).

Abbreviation: CI, confidence interval.

Table 7 Comparison of Demographic Data Among Other Studies

Variables	Our Study	Tonttila, Panu P, et al^7	Bansal, Somendra, et al^15	Siddiqui, M. Minhaj, et al^9	Porpiglia, Francesco, et al^6
Sample size (n)	75	113	96	582	223
Age ± SD (Years)/Range	66.31 ± 7.9	63±6.8	64.4±7.5	61.3±8.4	60 (58–70)
Median Serum P.S.A with IQR(ng/mL)	10.6 (4.5–20)	6.5 (4.2–10.7)	8.6 (6.3–12.5)	9.9 (mean)	6.3 (4.8–8.5)
Mean Prostate vol± SD/mean with IQR(cc)	45.67 ± 18.9 cc	29.8 (23.5–44.3)	41 (30.4–55)	56.4±31.2	46.2 (34.5–71.6)
Abnormal DRE %	34.6	12	24	Na	Na
Suspicious MRI lesions(n)	163	53	176	Na	Na