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CompletedNCT05902637MAPROSTATEUpdated Feb 25, 2025

The Efficacy of Mapping for Cognitive Prostate Biopsy

An interventional study of Performing cognitive prostate biopsy with a radiologist's guidance with map and Performing cognitive prostate biopsy without a radiologist's guidance with map in Prostate Cancer, Prostate Adenocarcinoma and Prostatic Neoplasms, sponsored by Marmara University. Completed at 1 site in Turkey. Open to male participants aged 40 Years to 90 Years. Per ClinicalTrials.gov, last updated 2025-02-25.

Sponsored by Marmara University · Not applicable, Interventional, and Diagnostic

Phase
Not applicable
Study type
Interventional
Enrollment
175
Allocation
Not applicable
Ages
40 Years to 90 Years
Sex
Male
01

Study summary

Today, many centers still perform Magnetic Resonance Imaging (MRI) cognitive prostate biopsy. The efficacy of detecting clinically significant prostate cancer, which is thought to be due to the experience of the urologist who performed the sampling and the difference in experience of the radiologists who performed the Multiparametric Prostate Magnetic Resonance (MPMR) evaluation, has been reported between 25% and 34% in the literature.

In order to eliminate this reporting and sampling difference, The goal of this interventional study is to compare the effectiveness of Multiparametric Prostate Magnetic Resonance (MPMR) Imaging routinely taken before biopsy with a single-center randomized and prospective study and prostate biopsies to be performed by the same urologist with the mapping technique created by a single genitourinary radiologist working in our center with standard cognitive prostate biopsy and to contribute to the literature Type of study: Clinical trial participant population: Male patients with elevated serum Prostate Specific Antigen (PSA) or indicated prostate biopsy by Magnetic Resonance Imaging (MRI) imaging and underwent Multiparametric Prostate Magnetic Resonance (MPMR) before the procedure Participants will undergo transrectal prostate biopsy with or without mapping, Researches will compare to see if the cancer detection rates differ

Read the detailed description

In this preliminary clinical study, 200 patients who underwent cognitive prostate biopsy under the guidance of transrectal ultrasonography between 01.03.2023 and 01.09.2023 by Marmara University Department of Urology, Department of Urooncology due to serum Prostate Specific Antigen (PSA) elevation and/or abnormal rectal examination findings will be included in the study. All patients will undergo prostate biopsy under local or general anesthesia with transrectal ultrasonography by a single surgeon after mapping or report is extracted by a single genitourinary radiologist in the Department of Radiology of our hospital.

In the power analysis, 200 patients were included in the study with the prediction that the efficacy difference would be calculated as 5%. All patients will be randomized to two equal groups by the flip-flip method.

  1. Multiparametric Prostate Magnetic Resonance Imaging and reports of the mapped patients will be examined and cognitive prostate biopsy will be performed by looking at the map (Sample Figure 1,2) created by the same urologist and the same radiologist (Sample Figure 1,2). Standard 12 core (6 peripheral zones from both lobes) will be sampled and 4 extra biopsies will be taken from Prostate Imaging-Reporting and Data System (PI-RADS) Category 3-4-5 areas in the mapping.
  2. Based on the Multiparametric Prostate Magnetic Resonance Imaging reports and images, without mapping by the radiologist, only the standard 12 core (6 from each peripheral zone from both lobes) determined cognitively by the urologist and 4 extra biopsies from the Prostate Imaging-Reporting and Data System (PI-RADS) Category 3-4-5 areas described in the report will be taken.

And then the biopsy results will be compared to see the efficacy of mapping

02

Conditions studied

  • Prostate Cancer
  • Prostate Adenocarcinoma
  • Prostatic Neoplasms
  • Prostate Disease
  • Prostate Cancer Stage

Keywords

  • Prostate
  • Cancer
  • Mapping
  • Genitourinary Radiology
  • Transrectal
  • Biopsy
  • Rectal examination
  • Method
  • Efficacy
  • Prostate mapping
  • Cognitive
  • prospective
  • Randomized
03

Who can participate

Ages eligible
40 Years to 90 Years
Sexes eligible
Male
Accepts healthy volunteers
No

Inclusion criteria

  • Patients with elevated serum Prostate Specific Antigen (PSA)
  • Indicated prostate biopsy by MR imaging and underwent Multiparametric Prostate Magnetic Resonance (MPMR) imaging before the procedure

Exclusion criteria

Exclusion Criteria:

  • Patients with suspicious Rectal Examination findings
  • Patients who cannot enter Multiparametric Prostate Magnetic Resonance (MPMR) imaging for various reasons (such as Multiparametric Prostate Magnetic Resonance (MPMR) imaging incompatible pacemaker, Chronic Kidney Disease)
  • Patients with diagnosed prostate cancer and active surveillance
  • Patients without indication for prostate biopsy
  • Patients with very high serum Prostate Specific Antigen (PSA) levels (>15)
  • Patients who are planned to start treatment by diagnosing with standard 12 core biopsy without losing time with imaging method
  • Patients who do not want to participate in the study.
04

Study design

Phase
Not applicable
Primary purpose
Diagnostic
Allocation
Not applicable
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
175 participants (actual)

Study arms

  • Active comparator
    Prostate Mapping Used

    Those patients' Multiparametric Prostate Magnetic Resonance (MPMR) imaging's have been assessed by a genitourinary radiologist to guide the surgeon who performs cognitive prostate biopsy

    Procedure: Performing cognitive prostate biopsy with a radiologist's guidance with map

  • Sham comparator
    Prostate Mapping not Used

    Those patients' Multiparametric Prostate Magnetic Resonance (MPMR) imaging's have not been assessed by a genitourinary radiologist to guide the surgeon who performs cognitive prostate biopsy. Surgeon assesses the Multiparametric Prostate Magnetic Resonance (MPMR) imaging's by him/herself

    Procedure: Performing cognitive prostate biopsy without a radiologist's guidance with map

Interventions

  • ProcedurePerforming cognitive prostate biopsy with a radiologist's guidance with map

    All patients will undergo prostate biopsy under local or general anesthesia with transrectal ultrasonography by a single surgeon after mapping extracted by a single genitourinary radiologist in the Department of Radiology of our hospital.

  • ProcedurePerforming cognitive prostate biopsy without a radiologist's guidance with map

    All patients will undergo cognitive prostate biopsy under local or general anesthesia with transrectal ultrasonography by a single surgeon after reported by a single genitourinary radiologist in the Department of Radiology of our hospital.

05

What researchers measure

Primary outcomes

  1. Detecting prostate cancer

    Detection of any kind or any grade of prostate cancer on the pathological specimen of Transrectal Ultrasound Guided Prostate Biopsy: * Detection of prostate adenocarcinoma of any ISUP (grade 1, grade 2, grade 3, grade 4 or grade 5) / Gleason score (Gleason score 6-10) * Detection of non-adenocarcinoma cancers of prostate (small cell carcinoma, neuroendocrine tumor, sarcomatous carcinoma, signet ring cell, basaloid carcinoma, pseudohyperplastic carcinoma, lymphoepithelioma-like carcinoma, adenosquamous cell carcinoma)

    Time frame: 6 months

06

Study locations

1 site
  • Marmara University, School of Medicine, Department of Urology
    Istanbul, 34890, Turkey
07

References and documents

Publications

  • Culp MB, Soerjomataram I, Efstathiou JA, Bray F, Jemal A. Recent Global Patterns in Prostate Cancer Incidence and Mortality Rates. Eur Urol. 2020 Jan;77(1):38-52. doi: 10.1016/j.eururo.2019.08.005. Epub 2019 Sep 5. PubMed 31493960 ↗
  • Bell KJ, Del Mar C, Wright G, Dickinson J, Glasziou P. Prevalence of incidental prostate cancer: A systematic review of autopsy studies. Int J Cancer. 2015 Oct 1;137(7):1749-57. doi: 10.1002/ijc.29538. Epub 2015 Apr 21. PubMed 25821151 ↗
  • Jansson KF, Akre O, Garmo H, Bill-Axelson A, Adolfsson J, Stattin P, Bratt O. Concordance of tumor differentiation among brothers with prostate cancer. Eur Urol. 2012 Oct;62(4):656-61. doi: 10.1016/j.eururo.2012.02.032. Epub 2012 Feb 24. PubMed 22386193 ↗
  • Lendinez-Cano G, Ojeda-Claro AV, Gomez-Gomez E, Morales Jimenez P, Flores Martin J, Dominguez JF, Amores J, Cozar JM, Bachiller J, Juarez A, Linares R, Garcia Galisteo E, Alvarez Ossorio JL, Requena Tapia MJ, Moreno Jimenez J, Medina Lopez RA; AEU-PIEM/2018/000 Investigators. Prospective study of diagnostic accuracy in the detection of high-grade prostate cancer in biopsy-naive patients with clinical suspicion of prostate cancer who underwent the Select MDx test. Prostate. 2021 Sep;81(12):857-865. doi: 10.1002/pros.24182. Epub 2021 Jun 29. PubMed 34184761 ↗
  • Oerther B, Engel H, Bamberg F, Sigle A, Gratzke C, Benndorf M. Cancer detection rates of the PI-RADSv2.1 assessment categories: systematic review and meta-analysis on lesion level and patient level. Prostate Cancer Prostatic Dis. 2022 Feb;25(2):256-263. doi: 10.1038/s41391-021-00417-1. Epub 2021 Jul 6. PubMed 34230616 ↗
  • Barkovich EJ, Shankar PR, Westphalen AC. A Systematic Review of the Existing Prostate Imaging Reporting and Data System Version 2 (PI-RADSv2) Literature and Subset Meta-Analysis of PI-RADSv2 Categories Stratified by Gleason Scores. AJR Am J Roentgenol. 2019 Apr;212(4):847-854. doi: 10.2214/AJR.18.20571. Epub 2019 Feb 26. PubMed 30807218 ↗
  • Presti JC Jr. Prostate biopsy: how many cores are enough? Urol Oncol. 2003 Mar-Apr;21(2):135-40. doi: 10.1016/s1078-1439(03)00006-1. PubMed 12856642 ↗
  • Wegelin O, Exterkate L, van der Leest M, Kummer JA, Vreuls W, de Bruin PC, Bosch JLHR, Barentsz JO, Somford DM, van Melick HHE. The FUTURE Trial: A Multicenter Randomised Controlled Trial on Target Biopsy Techniques Based on Magnetic Resonance Imaging in the Diagnosis of Prostate Cancer in Patients with Prior Negative Biopsies. Eur Urol. 2019 Apr;75(4):582-590. doi: 10.1016/j.eururo.2018.11.040. Epub 2018 Dec 3. PubMed 30522912 ↗

Individual participant data

Plan to share: No

08

Registry details

Key details

Study ID
NCT05902637
Lead sponsor
Marmara University
Responsible party
Tarik Emre Sener (Associating Professor, MD, Marmara University) — Principal investigator
First posted
Jun 15, 2023
Start date
Mar 1, 2023
Primary completion
Sep 1, 2024
Completion
Dec 1, 2024
Last update
Feb 25, 2025

Study contacts

Haydar Kamil Cam, Prof.
study chair · Marmara University, School of Medicine, Department of Urology

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
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