Fusion US/MRI prostate biopsy using a Computer Aided Diagnostic (CAD) system

Mariaconsiglia Ferriero, Umberto Anceschi, Alfredo M Bove, Luca Bertini, Rocco S Flammia, Guglielmo Zeccolini, Bernardino De Concilio, Gabriele Tuderti, Riccardo Mastroianni, Leonardo Misuraca, Aldo Brassetti, Salvatore Guaglianone, Michele Gallucci, Antonio Celia, Giuseppe Simone

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: To investigate the impact of Computer Aided Diagnostic (CAD) system on the detection rate of prostate cancer (PCa) in a series of fusion prostate biopsy (FPB).

METHODS: Two prospective transperineal FPB series (with or without CAD assistance) were analyzed and PCa detection rates compared with per patient and per target analyses. Chi-Square and Mann-Whitney test were used to compare categorical and continuous variables, respectively. Univariable and multivariable regression analyses were applied to identify predictors of any and clinically-significant (cs) PCa detection. Subgroup analyses were performed after stratifying for PIRADS Score and lesion location.

RESULTS: Out of 183 FPB, 89 were performed with CAD assistance. At per patient analysis the detection rate of any PCa and of cs PCa were 56.3% and 30.6%, respectively; the aid of CAD was negligible for either any PCa or csPCa detection rates (p=0.45 and p=0.99, respectively). Conversely in a per target analysis, CAD-assisted biopsy had significantly higher positive predictive value (PPV) for any PCa versus MRI-only group (58%vs37.8%, p=0.001). PI-RADS Score was the only independent predictor of any and csPCa, either in per patient or per target multivariable regression analysis (all p<0.029). In a subgroup per patient analysis of anterior/transitional zone lesions, csPCa detection rate was significantly higher in the CAD cohort (54.5%vs11.1%, respectively; p=0.028), and CAD assistance was the only predictor of csPCa detection (p=0.013).

CONCLUSIONS: CAD assistance for FPB seems to improve detection of csPCa located in anterior/transitional zone. Enhanced identification and improved contouring of lesions may justify higher diagnostic performance.

Original languageEnglish
JournalMinerva urologica e nefrologica = The Italian journal of urology and nephrology
DOIs
Publication statusE-pub ahead of print - Nov 12 2020

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