Table 4.
Summary table of the avoided targeted biopsy sessions and prostate cancer diagnoses missed when using the largest index lesion diameter or PSA density as a stratification tool.
| Thresholds | TBx Sessions | ISUP Grade 1 PCa | ISUP Grade ≥2 PCa | ISUP grade ≥2 with CR and/or IDC PCa | ISUP Grade ≥3 PCa | |
|---|---|---|---|---|---|---|
| Largest Index Lesion Diameter | PSA-Density | Avoided (n, %) | Not Detected (n, %) | Missed Diagnosis (n, %) | Missed Diagnosis (n, %) | Missed Diagnosis (n, %) |
| Monitor all patients | 292 (100%) | 53 (100%) | 39 (100%) | 20 (100%) | 10 (100%) | |
| Biopsy all patients | 0 (%) | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) | |
| ≥4 mm | - | 3 (1%) | 3 (6%) | 0 (0%) | 0 (0%) | 0 (0%) |
| ≥5 mm | - | 11 (4%) | 5 (9%) | 1 (3%) | 1 (5%) | 0 (0%) |
| ≥6 mm | - | 19 (7%) | 10 (19%) | 1 (3%) | 1 (5%) | 0 (0%) |
| ≥7 mm | - | 29 (10%) | 14 (26%) | 2 (5%) | 2 (10%) | 1 (10%) |
| ≥8 mm | - | 41 (14%) | 16 (30%) | 5 (13%) | 3 (15%) | 2 (20%) |
| - | ≥0.05 ng/mL2 | 5 (2%) | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) |
| - | ≥0.10 ng/mL2 | 55 (20%) | 4 (1%) | 2 (5%) | 1 (5%) | 1 (10%) |
| - | ≥0.11 ng/mL2 | 73 (25%) | 6 (11%) | 2 (5%) | 1 (5%) | 1 (10%) |
| - | ≥0.12 ng/mL2 | 91 (31%) | 9 (17%) | 3 (8%) | 1 (5%) | 1 (10%) |
| - | ≥0.15 ng/mL2 | 141 (48%) | 14 (26%) | 5 (13%) | 1 (5%) | 1 (10%) |
| - | ≥0.20 ng/mL2 | 183 (63%) | 19 (36%) | 10 (26%) | 2 (10%) | 2 (20%) |
PSA: prostate-specific antigen; TBx: targeted biopsy; ISUP: International Society of Urological Pathology; PCa: prostate cancer; CR: cribriform growth pattern; IDC: intraductal carcinoma.