Ipsilateral Versus Bilateral Systematic Biopsy Combined With MRI/Ultrasound Cognitive Fusion Targeted Biopsy for Prostate Cancer Diagnosis (IBIS-PC)
A Prospective, Multicenter, Open-Label, Randomized, Parallel-Group, Noninferiority Trial of MRI/Ultrasound Cognitive Fusion Targeted Biopsy Combined With Ipsilateral Versus Bilateral Systematic Biopsy for Prostate Cancer Diagnosis
Prostate biopsy usually combines magnetic resonance imaging/ultrasound (MRI/US) cognitive fusion targeted biopsy with systematic biopsy. Standard bilateral systematic biopsy requires sampling from both sides of the prostate and may increase the number of biopsy cores, procedural discomfort, procedure time, pathological workload, and biopsy-related complications.
This prospective, multicenter, open-label, randomized noninferiority trial will enroll 454 biopsy-naive men with suspected prostate cancer, a unilateral prostate MRI lesion with a highest PI-RADS score of 4 or 5, and prostate-specific antigen levels of 20 ng/mL or lower. Participants will be randomly assigned in a 1:1 ratio to receive transperineal MRI/US cognitive fusion targeted biopsy combined with either a 6-core ipsilateral systematic biopsy or a standard 12-core bilateral systematic biopsy.
The primary objective is to determine whether the ipsilateral systematic biopsy strategy is noninferior to the bilateral systematic biopsy strategy for detecting clinically significant prostate cancer, defined as International Society of Urological Pathology Grade Group 2 or higher. The study will also compare overall prostate cancer detection, biopsy core numbers, pain and discomfort, procedure time, pathological workload and costs, urinary symptoms, quality of life, and biopsy-related adverse events and complications through 30 days after biopsy.
연구 개요
상태
모병
정황
연구 유형
중재적
등록 (추정된)
454
단계
- 해당 없음
연락처 및 위치
이 섹션에서는 연구를 수행하는 사람들의 연락처 정보와 이 연구가 수행되는 장소에 대한 정보를 제공합니다.
연구 연락처
- 이름: Haifeng Huang
- 전화번호: +86-186-5165-8099
- 이메일: 24083491@qq.com
연구 장소
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Jiangsu
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Nanjing, Jiangsu, 중국
- 모병
- Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School
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연락하다:
- Haifeng Huang
- 전화번호: +86-186-5165-8099
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참여기준
연구원은 적격성 기준이라는 특정 설명에 맞는 사람을 찾습니다. 이러한 기준의 몇 가지 예는 개인의 일반적인 건강 상태 또는 이전 치료입니다.
자격 기준
공부할 수 있는 나이
- 성인
- 고령자
건강한 자원 봉사자를 받아들입니다
아니
설명
Inclusion Criteria:
- Male participants older than 18 years.
- Suspected prostate cancer and scheduled to undergo transperineal prostate biopsy.
- Prostate MRI showing a unilateral lesion with a highest Prostate Imaging Reporting and Data System (PI-RADS) score of 4 or 5.
- Serum prostate-specific antigen (PSA) level of 20 ng/mL or lower.
- Able to tolerate and undergo transperineal prostate biopsy.
- Willing to participate in the study and able to provide written informed consent.
Exclusion Criteria:
- Prior prostate biopsy.
- Prior prostate-related treatment or procedure that may affect pathological assessment or interpretation of the biopsy results, including but not limited to androgen deprivation therapy for prostate cancer, radiotherapy, focal therapy, or transurethral prostate surgery.
- Prostate MRI showing a lesion crossing the prostatic midline such that the lesion side cannot be clearly determined, or an independent contralateral lesion with a PI-RADS score of 3 or higher.
- Acute urinary tract infection, severe coagulation disorder, or any other contraindication to transperineal prostate biopsy.
- In the investigator's judgment, inability to understand the study, comply with study procedures, or provide written informed consent.
공부 계획
이 섹션에서는 연구 설계 방법과 연구가 측정하는 내용을 포함하여 연구 계획에 대한 세부 정보를 제공합니다.
연구는 어떻게 설계됩니까?
디자인 세부사항
- 주 목적: 특수 증상
- 할당: 무작위
- 중재 모델: 병렬 할당
- 마스킹: 하나의
무기와 개입
참가자 그룹 / 팔 |
개입 / 치료 |
|---|---|
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실험적: TB+iSB
Participants will undergo transperineal MRI/ultrasound cognitive fusion targeted biopsy of all PI-RADS 3 or higher lesions on the MRI lesion side, with 3 targeted cores obtained from each lesion.
Targeted biopsy will be followed by a 6-core ipsilateral systematic biopsy covering the medial and lateral regions of the base, midgland, and apex on the MRI lesion side.
Local anesthesia will be administered only on the MRI lesion side.
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Transperineal MRI/ultrasound cognitive fusion targeted biopsy will be performed for all PI-RADS 3 or higher lesions on the MRI lesion side, with 3 cores obtained from each lesion.
This will be followed by a 6-core systematic biopsy limited to the MRI lesion side, sampling the medial and lateral regions of the base, midgland, and apex.
Local anesthesia will be limited to the MRI lesion side.
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활성 비교기: TB+SB
Participants will undergo transperineal MRI/ultrasound cognitive fusion targeted biopsy of all PI-RADS 3 or higher lesions on the MRI lesion side, with 3 targeted cores obtained from each lesion.
Targeted biopsy will be followed by a standard 12-core bilateral systematic biopsy covering the medial and lateral regions of the base, midgland, and apex on both sides of the prostate.
Bilateral local anesthesia will be administered.
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Transperineal MRI/ultrasound cognitive fusion targeted biopsy will be performed for all PI-RADS 3 or higher lesions on the MRI lesion side, with 3 cores obtained from each lesion.
This will be followed by a standard 12-core bilateral systematic biopsy sampling the medial and lateral regions of the base, midgland, and apex on both sides of the prostate.
Bilateral local anesthesia will be administered.
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연구는 무엇을 측정합니까?
주요 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
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Detection Rate of Clinically Significant Prostate Cancer
기간: Day 14 after biopsy
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The proportion of participants with clinically significant prostate cancer detected by the assigned biopsy strategy.
Clinically significant prostate cancer is defined as biopsy pathology showing International Society of Urological Pathology (ISUP) Grade Group 2 or higher.
The between-group risk difference will be calculated as TB+iSB minus TB+SB.
Noninferiority will be concluded if the lower bound of the two-sided 95% confidence interval is greater than -15%.
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Day 14 after biopsy
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2차 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
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Overall Prostate Cancer Detection Rate
기간: Day 14 after biopsy
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The proportion of participants with prostate cancer detected on any biopsy specimen, regardless of ISUP Grade Group.
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Day 14 after biopsy
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Clinically Insignificant Prostate Cancer Detection Rate
기간: Day 14 after biopsy
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The proportion of participants with biopsy pathology showing ISUP Grade Group 1 prostate cancer and no lesion with ISUP Grade Group 2 or higher.
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Day 14 after biopsy
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High-Grade Prostate Cancer Detection Rate
기간: Day 14 after biopsy
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The proportion of participants with biopsy pathology showing ISUP Grade Group 3 or higher.
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Day 14 after biopsy
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Pain Numeric Rating Scale Score
기간: Within 30 minutes after biopsy and at 24 hours after biopsy; additionally at day 7 (±2 days) among participants with persistent pain
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Biopsy-related pain associated with local anesthesia, needle puncture, and biopsy core acquisition will be assessed using an 11-point Numeric Rating Scale ranging from 0 to 10.
A score of 0 indicates no pain and a score of 10 indicates the worst imaginable pain.
Higher scores indicate greater pain.
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Within 30 minutes after biopsy and at 24 hours after biopsy; additionally at day 7 (±2 days) among participants with persistent pain
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Overall Discomfort Numeric Rating Scale Score
기간: Within 30 minutes after biopsy and at 24 hours after biopsy; additionally at day 7 (±2 days) among participants with persistent discomfort
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Overall procedural discomfort related to instrument insertion, ultrasound positioning or pressure, prostatic pressure, pelvic floor traction, foreign-body sensation, positioning, and the biopsy procedure will be assessed using an 11-point Numeric Rating Scale ranging from 0 to 10.
A score of 0 indicates no discomfort and a score of 10 indicates the worst imaginable discomfort.
Higher scores indicate greater discomfort.
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Within 30 minutes after biopsy and at 24 hours after biopsy; additionally at day 7 (±2 days) among participants with persistent discomfort
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Procedure Time
기간: During the biopsy procedure
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Procedure time in minutes, measured from the start of local anesthesia to completion of the final biopsy core.
For the TB+iSB group, timing begins when local anesthesia is started on the MRI lesion side.
For the TB+SB group, timing begins when bilateral local anesthesia is started.
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During the biopsy procedure
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Total Number of Biopsy Cores
기간: During the biopsy procedure
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The total number of biopsy cores, including MRI-targeted and systematic biopsy cores, obtained for each participant will be recorded.
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During the biopsy procedure
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Number of Pathology Specimen Containers
기간: Periprocedural
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The total number of pathology specimen containers generated from the biopsy procedure will be recorded for each participant.
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Periprocedural
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Total Pathology-Related Costs
기간: Up to 2 weeks after biopsy
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Total pathology-related costs associated with biopsy specimen handling, processing, histological examination, and pathology reporting will be obtained from the applicable hospital records for each participant.
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Up to 2 weeks after biopsy
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Incidence of Biopsy-Related Adverse Events and Complications
기간: From biopsy through 30 days after biopsy; assessed within 30 minutes, at 24 hours, day 7 (±2 days), and day 30 (±7 days)
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The proportion of participants experiencing any biopsy-related adverse event or complication will be assessed.
Events include gross hematuria, hematospermia, perineal hematoma, fever or infection, urinary retention, syncope, emergency department visits, unplanned or prolonged hospitalization, serious adverse events, and additional medical interventions required because of a complication.
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From biopsy through 30 days after biopsy; assessed within 30 minutes, at 24 hours, day 7 (±2 days), and day 30 (±7 days)
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Severity of Biopsy-Related Complications by Clavien-Dindo Grade
기간: From biopsy through 30 days after biopsy
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The maximum Clavien-Dindo grade of biopsy-related complications will be recorded for each participant.
Grades range from I to V, with higher grades indicating greater severity: Grade I indicates a minor deviation from the expected postoperative course; Grade II requires pharmacological treatment; Grade III requires an intervention; Grade IV indicates a life-threatening complication requiring intensive care; and Grade V indicates death.
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From biopsy through 30 days after biopsy
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Change From Baseline in International Prostate Symptom Score
기간: Baseline and 7 days after biopsy (±2 days)
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The International Prostate Symptom Score consists of 7 questions assessing lower urinary tract symptoms.
The total score ranges from 0 to 35, with higher scores indicating more severe urinary symptoms.
Change from baseline will be calculated as the score at 7 days after biopsy minus the baseline score.
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Baseline and 7 days after biopsy (±2 days)
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Change From Baseline in IPSS Quality of Life Score
기간: Baseline and 7 days after biopsy (±2 days)
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The quality of life question associated with the International Prostate Symptom Score ranges from 0 to 6, with higher scores indicating greater dissatisfaction with the participant's urinary condition.
Change from baseline will be calculated as the score at 7 days after biopsy minus the baseline score.
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Baseline and 7 days after biopsy (±2 days)
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Number of Histology Slides
기간: Up to 2 weeks after biopsy
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The total number of histology slides generated for biopsy specimen processing and pathological diagnosis will be recorded for each participant.
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Up to 2 weeks after biopsy
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기타 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
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Real-Time Ultrasound Visibility of MRI-Suspicious Lesions
기간: During MRI/ultrasound cognitive fusion targeted biopsy
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Each MRI-suspicious lesion designated as L1, L2, or L3 will be classified according to whether it can be identified on real-time ultrasound during MRI/ultrasound cognitive fusion targeted biopsy.
Categories are visible, not visible, uncertain, and not applicable.
The number and proportion of MRI-suspicious lesions in each category will be reported.
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During MRI/ultrasound cognitive fusion targeted biopsy
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ISUP Grade Group Concordance Between Biopsy and Radical Prostatectomy Pathology
기간: Up to 6 months after biopsy
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Among participants who undergo radical prostatectomy, the relationship between biopsy ISUP Grade Group and radical prostatectomy ISUP Grade Group will be classified into three mutually exclusive categories: concordant, upgraded, or downgraded.
Concordant is defined as the same ISUP Grade Group on biopsy and radical prostatectomy pathology; upgraded is defined as a higher ISUP Grade Group on radical prostatectomy pathology than on biopsy pathology; and downgraded is defined as a lower ISUP Grade Group on radical prostatectomy pathology than on biopsy pathology.
The number and proportion of participants in each category will be reported.
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Up to 6 months after biopsy
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여기에서 이 연구와 관련된 사람과 조직을 찾을 수 있습니다.
간행물 및 유용한 링크
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연구 기록 날짜
이 날짜는 ClinicalTrials.gov에 대한 연구 기록 및 요약 결과 제출의 진행 상황을 추적합니다. 연구 기록 및 보고된 결과는 공개 웹사이트에 게시되기 전에 특정 품질 관리 기준을 충족하는지 확인하기 위해 국립 의학 도서관(NLM)에서 검토합니다.
연구 주요 날짜
연구 시작 (실제)
2026년 7월 20일
기본 완료 (추정된)
2027년 3월 1일
연구 완료 (추정된)
2027년 4월 1일
연구 등록 날짜
최초 제출
2026년 8월 5일
QC 기준을 충족하는 최초 제출
2026년 8월 27일
처음 게시됨 (실제)
2026년 8월 31일
연구 기록 업데이트
마지막 업데이트 게시됨 (실제)
2026년 8월 31일
QC 기준을 충족하는 마지막 업데이트 제출
2026년 8월 27일
마지막으로 확인됨
2026년 7월 1일
추가 정보
이 연구와 관련된 용어
키워드
추가 관련 MeSH 약관
기타 연구 ID 번호
- IUNU-PC-131
- 2026-0723-02 (기타 식별자: Medical Ethics Committee of Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School)
개별 참가자 데이터(IPD) 계획
개별 참가자 데이터(IPD)를 공유할 계획입니까?
미정
IPD 계획 설명
An individual participant data sharing plan has not yet been finalized.
Any future sharing of de-identified participant data will be considered only with approval from the sponsor and the relevant ethics committee and in accordance with applicable laws, regulations, and privacy protection requirements.
약물 및 장치 정보, 연구 문서
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미국 FDA 규제 기기 제품 연구
아니
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