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. 2021 Jan;39(1):73.e1-73.e8.
doi: 10.1016/j.urolonc.2020.07.009. Epub 2020 Aug 7.

The effect of delaying transperineal fusion biopsy of the prostate for patients with suspicious MRI findings-Implications for the COVID-19 era

Ziv Savin  1 , Snir Dekalo  1 , Ron Marom  1 , Sophie Barnes  2 , Gilad Gitstein  3 , Nicola J Mabjeesh  4 , Haim Matzkin  1 , Ofer Yossepowitch  1 , Gal Keren-Paz  1 , Roy Mano  5
Affiliations

The effect of delaying transperineal fusion biopsy of the prostate for patients with suspicious MRI findings-Implications for the COVID-19 era

Ziv Savin et al. Urol Oncol. 2021 Jan.

Abstract

Objective: Image guided biopsies are an integral part of prostate cancer evaluation. The effect of delaying biopsies of suspicious prostate mpMRI lesions is uncertain and clinically relevant during the COVID-19 crisis. We evaluated the association between biopsy delay time and pathologic findings on subsequent prostate biopsy.

Materials and methods: After obtaining IRB approval we reviewed the medical records of 214 patients who underwent image-guided transperineal fusion biopsy of the prostate biopsy between 2017 and 2019. Study outcomes included clinically significant (ISUP grade group ≥2) and any prostate cancer on biopsy. Logistic regression was used to evaluate the association between biopsy delay time and outcomes while adjusting for known predictors of cancer on biopsy.

Results: The study cohort included 195 men with a median age of 68. Median delay between mpMRI and biopsy was 5 months, and 90% of patients had a ≤8 months delay. A significant association was found between PI-RADS 5 lesions and no previous biopsies and shorter delay time. Delay time was not associated with clinically significant or any cancer on biopsy. A higher risk of significant cancer was associated with older age (P = 0.008), higher PSA (0.003), smaller prostate volume (<0.001), no previous biopsy (0.012) and PI-RADS 5 lesions (0.015).

Conclusions: Our findings suggest that under current practice, where men with PI-RADS 5 lesions and no previous biopsies undergo earlier evaluation, a delay of up to 8 months between imaging and biopsy does not affect biopsy findings. In the current COVID-19 crisis, selectively delaying image-guided prostate biopsies is unlikely to result in a higher rate of significant cancer.

Keywords: Image guided prostate biopsy; Magnetic resonance imaging; Prostate cancer; Treatment delay.

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Conflict of interest statement

Conflict of Interest All authors declare that they have nothing to disclose.

Figures

Fig 1
Fig. 1
Highest grade of prostate cancer detected in patients undergoing prostate biopsy (n = 195) categorized by (A) biopsy type – systematic, targeted and combined and (B) Maximal PI-RADS score on prebiopsy multiparametric MRI.
Fig 2
Fig. 2
(A) Histogram of time interval between multiparametric MRI and prostate biopsy in patients who underwent a biopsy within 1 year of the imaging study (n = 195) and (B) Box-plot chart of biopsy delay time categorized by patients without evidence of cancer, with nonsignificant cancer and with significant cancer on biopsy.
See this image and copyright information in PMC

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