Comparative analysis of adverse events using different methods of prostate biopsy

Background. The indicator of detected cases of prostate cancer (PCa) in 2015 was 38,812. The standardized incidence rate was 40.23per 100,000population. Increase in the incidence of PCa from 2005 to 2015 — 135.5 %. The average annual growth rate is 7.76 %. The histological verification of PCa is of great importance in the diagnosis and subsequent choice of treatment tactics. Currently, the most common method of transrectal “blind” prostate biopsy is to control the control, which does not have sufficient sensitivity and specificity for detecting PCa, and the morphological result contains limited information about the aggressiveness and stage of cancer. In connection with the development of modern methods of magnetic resonance diagnostics, such as multiparametric magnetic resonance imaging, which is currently the most sensitive and specific imaging method for the diagnosis of PCa, methods of targeted prostate biopsy are increasingly used in clinical practice. Scientific work supports the rapidly growing use of multiparametric magnetic resonance imaging (MRI) as the most sensitive and specific imaging tool for detection, lesion characterisation and staging of PCa.

Objectiveis to the safety and frequency of complications of transperineal, transrectal, MRI/TRUS (magnetic resonance imaging/transrectal ultrasound) fusion targeted-biopsy.

Materials and methods.The fusion of magnetic resonance imaging data with transrectal ultrasound enables the targeted biopsy of suspicious areas. 142 consecutively selected patients were examined, mean age of 62.0 + 6.5 years. According to aim we assigned patients to 3 groups: 1^st group (n = 49) underwent repeated transrectal biopsy of the prostate; in patients of 2^nd group (n = 39) perineal biopsy of the prostate; in 3^rd group there were patients (n = 54) a targeted fusion biopsy with magnetic resonance imaging and transrectal ultrasound-navigation. Results. PCa was diagnosed in 26.5, 46.2 and 61.1 % respectively. The most frequent complication of biopsy of the prostate gland was hematuria. This symptom was found in 33.3 % patients of the 1^st group, 42.5 % in the 2^nd group and 42.2 % in the 3^rd group. The prolongation of hospitalization due to hematuria was required by 5patients (11.9 %) from 1^st group, 8 (17.0 %) from 2^nd and 5 (7.8 %) from group 3. Hospitalization and additional treatment was required in 8 (16.3 %) patients in 1^st group and 1 (2.5 %) in 2^nd group. Infectious-inflammatory complications are often diagnosed and require additional treatment. In 1^st group patients, this type of complication was observed in 16.3 %, 2^nd and 3^rd groups 5.1 % and 1.9 %, respectively. In 4.7 % of the patients in the 1^st group, sepsis was diagnosed, complications were not recorded in patients of groups 2^nd and 3^rd of the data group. When assessing the complications, there was a slight predominance of the complication rate of the standard transrectal biopsy procedure, but this difference was statistically insignificant (p >0.05).

Conclusion. We compared the security of standard biopsy and perineal biopsy to diagnose PCa against a novel approach using software to overlay the images from magnetic resonance imaging and ultrasound to guide biopsies towards the suspicious areas of the prostate. We found consistentfindings showing the superiority of this novel targeted approach, although further high-quality evidence is needed to change current practice. No significant statistical differences were found in the complications rates between.

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