ASO Author Reflections: A Pair of Nomograms to Choose Appropriate Prostate Biopsy Strategy
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Targeted biopsy (TB), based on the multiparametric magnetic resonance imaging (mpMRI) result, has been deemed better than traditional transrectal ultrasonography (TRUS)-guided systematic biopsy (SB) in detecting clinically significant prostate cancer (csPCa).1 Combined application of these two biopsy approaches will achieve a higher cancer detection rate than using TB alone;2 however, in some cases, detecting tumors by TB only is sufficient and adding SB may result in the diagnosis being repeated and may bring unexpected complications. Should we perform TB or SB, or should we choose a combination of the two methods? The optimal biopsy strategy may be different for each case.
Although several studies developed nomograms to predict the probability of PCa or csPCa, these studies only used one biopsy strategy, for which the ultimate goal was to determine the risk of cancer and thus determine whether the patient should receive a biopsy or not.3,4
Unlike those nomograms, the present paired nomograms in our study5 have been developed based on different biopsy strategies, aiming not merely at the determination of biopsy. More importantly, the nomogram also aims at the further choice of optimal biopsy strategy (TB only or TB combined with SB) for different patients.
The data in this study5 are from a single center only, and the nomograms we developed should be further validated in other institutes.
Bi-Ming He, Ying-Hao Sun, and Hai-Feng Wang report no conflicts of interest.
- 5.He B-M, Shi Z-K, Li H-S, et al. A novel prediction tool based on multiparametric magnetic resonance imaging to determine the biopsy strategy for clinically significant prostate cancer in patients with PSA levels less than 50 ng/ml. Ann Surg Oncol. 2019. https://doi.org/10.1245/s10434-019-08111-2.CrossRefPubMedPubMedCentralGoogle Scholar