Concordance of Gleason grading with three-dimensional ultrasound systematic biopsy and biopsy core pre-embedding

• Published in: World journal of urology Vol. 36; no. 6; pp. 863 - 869
• Main Authors: van der Aa, Anouk A. M. A., Mannaerts, Christophe K., van der Linden, Hans, Gayet, Maudy, Schrier, Bart Ph, Mischi, Massimo, Beerlage, Harrie P., Wijkstra, Hessel
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.06.2018; Springer Nature B.V
• Subjects: Biopsy; Cancer surgery; Embedding; Endoscopic Ultrasound-Guided Fine Needle Aspiration; Humans; Male; Medicine; Medicine & Public Health; Multivariate analysis; Neoplasm Grading; Nephrology; Netherlands; Oncology; Original Article; Prostate; Prostate - pathology; Prostate cancer; Prostatectomy; Prostatic Neoplasms - pathology; Prostatic Neoplasms - surgery; Regression analysis; Retrospective Studies; Ultrasonic imaging; Ultrasound; Urological surgery; Urology; Netherlands; Prostatectomy; Tissue embedding; Prostatic neoplasms; Neoplasm grading; Biopsy; Three-dimensional imaging
• ISSN: 0724-4983; 1433-8726
• DOI: 10.1007/s00345-018-2209-7

Purpose To determine the value of a three-dimensional (3D) greyscale transrectal ultrasound (TRUS)-guided prostate biopsy system and biopsy core pre-embedding method on concordance between Gleason scores of needle biopsies and radical prostatectomy (RP) specimens. Methods Retrospective analysis of prostate biopsies and subsequent RP for PCa in the Jeroen Bosch Hospital, the Netherlands, from 2007 to 2016. Two cohorts were analysed: conventional 2D TRUS-guided biopsies and RP (2007–2013, n  = 266) versus 3D TRUS-guided biopsies with pre-embedding (2013–2016, n  = 129). The impact of 3D TRUS-guidance with pre-embedding on Gleason score (GS) concordance between biopsy and RP was evaluated using the κ -coefficient. Predictors of biopsy GS 6 upgrading were assessed using logistic regression models. Results Gleason concordance was comparable between the two cohorts with a κ  = 0.44 for the 3D cohort, compared to κ  = 0.42 for the 2D cohort. 3D TRUS-guidance with pre-embedding, did not significantly affect the risk of biopsy GS 6 upgrading in univariate and multivariate analysis. Conclusions 3D TRUS-guidance with biopsy core pre-embedding did not improve Gleason concordance. Improved detection techniques are needed for recognition of low-grade disease upgrading.