Cognitive fusion-targeted biopsy versus transrectal ultrasonography-guided systematic biopsy: comparison and analysis of the risk of Gleason score upgrading

• Published in: International urology and nephrology 2024-03, Vol.56 (3), p.981-988
• Main Authors: Zheng, Tianyun, Bi, Kaipeng, Tang, Yueqing, Zeng, Yuan, Wang, Junyan, Yan, Lei
• Format: Article
• Language: English
• Subjects: Biopsy; Body mass index; Cognitive ability; Medicine; Medicine & Public Health; Nephrology; Prostate; Ultrasonic imaging; Urology; Urology - Original Paper
• ISSN: 1573-2584; 0301-1623; 1573-2584
• DOI: 10.1007/s11255-023-03848-y

Purpose The aim of this study is to assess the precision of the Gleason score (GS) obtained through cognitive fusion-targeted biopsy (COG-TB) in comparison to transrectal ultrasonography-guided systematic biopsy (TRUS-SB), and to identify factors that can predict Gleason score upgrading (GSU) in a cohort of Chinese patients. Methods A final enrollment of 245 patients was recorded. Between 2020 and 2022, 132 patients underwent TRUS-SB, and 113 patients underwent COG-TB. The Chi-square test was performed to analyze the variation in downgrading, concordance, and upgrading between TRUS-SB and COG-TB. Multivariable analyses were performed to seek factors predicting Gleason score upgrading. Finally, a model which utilizes multivariable logistic regression was developed to predict the likelihood of GSU. Results The concordance for TRUS-SB and COG-TB were 42.4% and 65.5%, respectively. TRUS-SB and COG-TB exhibited notable disparities in downgrading, concordance, and upgrading. Age, prostate volume, body mass index (BMI), and the biopsy modality were significant predictive factors. Conclusion COG-TB can significantly increase concordance with final histopathology. Age, prostate volume, BMI, and the biopsy modality were predictive factors of GSU.