ArticleAmerican journal of clinical oncology2018
Targeted Prostate Biopsy Gleason Score Heterogeneity and Implications for Risk Stratification.
Article in American journal of clinical oncology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed, 31 citations in OpenAlex.
- Association Between Cribriform Architecture and Tertiary Gleason Pattern 5 in Prostate Cancer: A Cross-Sectional Study of Radical Prostatectomy Specimens.Journal of clinical medicine · 2026Article
- Comparable recurrence risk for MRI-detected Gleason Grade Group (GG) 2 and systematic biopsy-detected GG1 prostate cancer.BJU international · 2026Article
- Low heterogeneity of tumor grades in multiple MRI-targeted prostate biopsies argues for the aggregate method of grading.Virchows Archiv : an international journal of pathology · 2026Article
- Transgluteal MRI-targeted biopsy versus transrectal systemic biopsy in prostate cancer diagnosis.International urology and nephrology · 2025Article
- Review
- Diagnostic Yield of Fusion-Guided and Randomized Biopsies in Prostate Cancer: Evidence for an Integrated Approach.Healthcare (Basel, Switzerland) · 2025Article
- Development and validation of [18 F]-PSMA-1007 PET-based radiomics model to predict biochemical recurrence-free survival following radical prostatectomy.European journal of nuclear medicine and molecular imaging · 2024Article
- Using active surveillance for Gleason 7 (3+4) prostate cancer: A narrative review.Canadian Urological Association journal = Journal de l'Association des urologues du Canada · 2024Review
- Risk factors for Gleason score upgrade from prostate biopsy to radical prostatectomy.Exploration of targeted anti-tumor therapy · 2024Review
- Prostate cancer risk stratification using magnetic resonance imaging-ultrasound fusion vs systematic prostate biopsy.JNCI cancer spectrum · 2023Article
- Knowledge, attitudes, and practices of active surveillance in prostate cancer among urologists: a real-life survey from Brazil.BMC urology · 2022Article
- CanEuropean journal of nuclear medicine and molecular imaging · 2021Article
- Mitochondrial DNA copy number in peripheral blood leukocytes is associated with biochemical recurrence in prostate cancer patients in African Americans.Carcinogenesis · 2020Article
- Leukocyte telomere length is associated with aggressive prostate cancer in localized prostate cancer patients.EBioMedicine · 2020Article
- PI-RADS Steering Committee: The PI-RADS Multiparametric MRI and MRI-directed Biopsy Pathway.Radiology · 2019Review
- Risk of Upgrading from Prostate Biopsy to Radical Prostatectomy Pathology-Does Saturation Biopsy of Index Lesion during Multiparametric Magnetic Resonance Imaging-Transrectal Ultrasound Fusion Biopsy Help?The Journal of urology · 2018Article
- Advances in medical imaging for the diagnosis and management of common genitourinary cancers.Urologic oncology · 2017Review
- Comparative Histological Quantification of Prostate Cancer on Surgical Specimens.Current health sciences journalArticle
- Spatial distribution of biopsy cores and the detection of intra-lesion pathologic heterogeneity.Therapeutic advances in urologyArticle
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
Abstract
objectivesTo quantify Gleason score (GS) heterogeneity within multiparametric magnetic resonance imaging (MRI)-targeted prostate biopsies and to determine impact on National Comprehensive Cancer Network (NCCN) risk stratification.
methodsAn Institutional Review Board-approved retrospective study was performed on men who underwent Artemis (MRI-transrectal-ultrasound fusion) targeted biopsy (TB) for suspected prostate cancer between 2012 and 2015. Intratarget heterogeneity was defined as a difference in GS between 2 cores within a single target in patients with ≥2 positive cores. Prostate specific antigen, maximum tumor diameter, apparent diffusion coefficient, MRI suspicion score, prostate volume, systematic biopsy (SB) GS, and T-stage were analyzed for correlation with heterogeneity. Changes in NCCN risk based on high versus low GS on TB, SB alone, and SB+TB were compared.
resultsFifty-three patients underwent TB of 73 suspected lesions. Seventy percent (51/73) had ≥2 positive cores, thus meeting inclusion criteria for heterogeneity analysis. Fifty-five percent (28/51) of qualifying targets showed GS heterogeneity. None of the evaluated factors showed a significant relationship with heterogeneity. NCCN low-risk, intermediate-risk, and high-risk groups were 30%, 49%, and 21%, respectively, with SB alone. Adding low GS TB to SB resulted in 17%, 55%, 28% in each risk group, while using high GS+SB resulted in 4%, 54%, and 42%. Overall, the addition of TB resulted in higher NCCN risk groups in 38% of cases.
conclusionsOver half of multiparametric MRI-defined targets demonstrated GS heterogeneity. The addition of high GS from TB leads to risk inflation compared with using SB alone. Further research is needed on how to integrate these findings into current risk stratification models and clinical practice.
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