MRI-targeted Fusion or Cognitive Ultrasound-guided Biopsy to Detect Prostate Cancer
Albany Medical College
Summary
The MRI-targeted biopsy for prostate cancer detection can be performed using one of two techniques: 1. Software-based fusion of MRI and ultrasound images (software fusion) or 2. Visually estimated MRI-informed (cognitive fusion) technique To date, there is a lack of adequately powered RCTs directly comparing the cognitive vs fusion targeted biopsy. This randomized study will directly compare the detection rates of clinically significant prostate cancer following either the cognitive or the fusion targeted prostate biopsy in men with suspicious lesions noted on multi-parametric MRI (mp-MRI) of prostate.
Description
For prostate cancer detection, pre-biopsy multi-parametric magnetic resonance imaging (mp-MRI) followed by MRI-targeted prostate biopsy is standard of care which is supported by the guidelines from the American Urological Association and the European Association of Urology. The MRI-targeted prostate biopsy is associated with a significant increase in the detection of clinically significant prostate cancer (csPCa) compared to the ultrasound guided biopsy. The MRI-targeted biopsy can be performed using one of two techniques including software-based fusion of MRI and ultrasound images (software f…
Eligibility
- Age range
- 18+ years
- Sex
- Male
- Healthy volunteers
- No
Inclusion Criteria: * Men undergoing prostate biopsy (either transrectal or transperineal) for suspected prostate cancer as part of their regular medical care * Must be eligible to undergo both prostate biopsy procedure (cognitive or fusion) * Men undergoing their first prostate biopsy procedure or with no previous prostate biopsy within 3 years * Pre-biopsy mp-MRI of prostate with one or more lesions classified as PIRADS 3-5 * Largest dimension of any lesion on mp-MRI to be ≤ 2 cm * Prostate-specific antigen level ≤ 20 ng/mL and/or abnormal digital rectal examination Exclusion Criteria: *…
Interventions
- ProcedureSoftware fusion prostate biopsy
Software fusion biopsy: Each participant in this study arm will first undergo biopsy of the MRI-detected lesion using an image fusion platform such as UroNav or similar. Three biopsy cores will be taken per lesion, with a maximum of three lesions being sampled per participant. Then systematic samples will be taken from the remainder of the prostate as per standard protocol (10-12 cores).
- ProcedureCognitive fusion prostate biopsy
Cognitive fusion biopsy: Each participant in this study arm will first undergo biopsy of the MRI-detected lesion using visual estimation and/or measurements of lesion. Three biopsy cores will be taken per lesion, with a maximum of three lesions being sampled per participant. Then systematic samples will be taken from the remainder of the prostate as per standard protocol (10-12 cores).
Locations (4)
- Lahey Clinic, IncBurlington, Massachusetts
- Albany Medical CenterAlbany, New York
- Pennsylvania State UniversityHershey, Pennsylvania
- Manitoba Prostate Centre, CancerCare ManitobaWinnipeg, Manitoba