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Reconciling Discordance Between Prostate Biopsy Histology and Magnetic Resonance Imaging Suspicion - Implementation of a Quality Improvement Protocol of Imaging Re-review and Reverse-fusion Target Analysis.

Publication ,  Journal Article
Kotamarti, S; Gupta, RT; Wang, B; Séguier, D; Michael, Z; Zhang, D; Abern, MR; Huang, J; Polascik, TJ
Published in: Eur Urol Oncol
October 2022

There is uncertainty with how to proceed when targeted prostate biopsy of suspicious multiparametric magnetic resonance imaging (mpMRI) lesions return without clinically significant prostate cancer (csPCa). While possible, there are error sources that could contribute to such discordance including the mpMRI read, mpMRI-ultrasound fusion, biopsy technique, and histologic classification. Consequences are potentially significant; mistakenly missing csPCa can lead to delays in curative treatment. Conversely, in cases of incorrect mpMRI interpretation, the patient may be subjected to unnecessary workup/burden. At our institution, we implemented a quality improvement (QI) initiative triggered after a discordant case occurs. This multidisciplinary review process incorporates mpMRI re-review and assessment of accurate lesion-sampling, termed "reverse-fusion." Herein, we describe the protocol, present sample cases, and discuss clinical implications.

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Published In

Eur Urol Oncol

DOI

EISSN

2588-9311

Publication Date

October 2022

Volume

5

Issue

5

Start / End Page

483 / 493

Location

Netherlands

Related Subject Headings

  • Quality Improvement
  • Prostatic Neoplasms
  • Prostate
  • Neoplasm Grading
  • Male
  • Magnetic Resonance Imaging
  • Humans
  • Biopsy
  • 3211 Oncology and carcinogenesis
  • 3202 Clinical sciences
 

Citation

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Kotamarti, S., Gupta, R. T., Wang, B., Séguier, D., Michael, Z., Zhang, D., … Polascik, T. J. (2022). Reconciling Discordance Between Prostate Biopsy Histology and Magnetic Resonance Imaging Suspicion - Implementation of a Quality Improvement Protocol of Imaging Re-review and Reverse-fusion Target Analysis. Eur Urol Oncol, 5(5), 483–493. https://doi.org/10.1016/j.euo.2022.06.007
Kotamarti, Srinath, Rajan T. Gupta, Bangchen Wang, Denis Séguier, Zoe Michael, Dylan Zhang, Michael R. Abern, Jiaoti Huang, and Thomas J. Polascik. “Reconciling Discordance Between Prostate Biopsy Histology and Magnetic Resonance Imaging Suspicion - Implementation of a Quality Improvement Protocol of Imaging Re-review and Reverse-fusion Target Analysis.Eur Urol Oncol 5, no. 5 (October 2022): 483–93. https://doi.org/10.1016/j.euo.2022.06.007.
Journal cover image

Published In

Eur Urol Oncol

DOI

EISSN

2588-9311

Publication Date

October 2022

Volume

5

Issue

5

Start / End Page

483 / 493

Location

Netherlands

Related Subject Headings

  • Quality Improvement
  • Prostatic Neoplasms
  • Prostate
  • Neoplasm Grading
  • Male
  • Magnetic Resonance Imaging
  • Humans
  • Biopsy
  • 3211 Oncology and carcinogenesis
  • 3202 Clinical sciences