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    Targeted biopsy: High-risk PCa detection rises 30%


    Researchers noted that 461 prostate cancer cases were diagnosed with targeted biopsy versus 469 cases with standard biopsy. Targeted and standard biopsies produced the same results in 69% of the cases. However, 30% more high-risk cancers were diagnosed through targeted biopsy than standard biopsy (173 vs. 122 cases) and 17% fewer low-risk cancers (213 vs. 258). Adding standard biopsy to targeted biopsy led to a 22% increase in cancer diagnoses, the vast majority of them for low-risk cancers.

    Researchers also found that targeted biopsy was better able to predict whether the disease was low- or intermediate risk than standard biopsy or the two approaches combined. They were able to make that determination by comparing biopsied tissue with tissue taken from a patient's prostate after it was later removed surgically.

    “Decisions to adopt new technologies such as this one that occupy a largely unregulated space ultimately rely on clinicians and payers, based on available data,” wrote Lawrence H. Schwartz, MD, of the Columbia University College of Physicians and Surgeons, New York, and Ethan Basch, MD, of the University of North Carolina, Chapel Hill, and associate editor of JAMA, in an accompanying editorial (JAMA 2015; 313:367-8.).

    “Any test that can inform decision making and potentially spare patients harm is immediately appealing, even if the effect on clinical outcomes is unknown. Nonetheless, a new test should not be widely adopted in the absence of direct evidence showing benefits on quality of life, life expectancy, or ideally both. Therefore, the scientific community has the responsibility to ensure through clinical research that promising new technologies such as MR/ultrasound fusion imaging-guided biopsies bring value to patients.”

    Dr. Pinto and co-author Peter L. Choyke, MD, reported holding a patent related to the MR/ultrasound fusion biopsy platform. Co-author Bradford J. Wood, MD, reported holding multiple related patents in the field.

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