Abstract
Purpose
We want to investigate whether MR-US fusion can improve the detection rates of clinically
significant prostate cancer in patients with prior negative prostate biopsy with PSA
level <10 ng/mL.
Methods
Thirty nine patients who had previous a history of negative prostate biopsy and PSA
levels <10 ng/mL were included in this study. MR was performed before the biopsy and
graded using PIRADS V2. We labeled patients with index lesions with PIRADS scores
of 3 or above as the MR-positive group, while patients with PIRADS scores of 1 or
2 were the MR-negative group. Two cores of added biopsy (AB) were performed per each
index lesion under MR-US fusion. Twelve cores randomized systematic biopsy (SB) were
followed. In MR negative group, two cores of AB were obtained in transition zone,
followed by SB. Overall cancer and clinically significant cancer detection rates by
patients and by cores were analyzed, and compared between MR-positive and negative
group.
Results
The overall cancer detection rates were 51.3% by patient based and 13.8% by core based.
While all of AB positive cancer patients were clinically significant cancer patients,
five out of seven (71.4%) AB negative cancer patients were clinically insignificant
cancer patients. AB results turned another four cancer patients from insignificant
to significant cancer. The cancer detection rates between MR-positive and negative
group were statistically significant.
Conclusions
Additional biopsy using MR–US fusion showed improved detection of clinically significant
prostate cancer.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic and PersonalCorporate R&D ProfessionalsOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Clinical ImagingAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Cancer statistics, 2012.CA Cancer J Clin. 2012; 62: 10-29
- Prostate cancer in elderly men.Rev Urol. 2008; 10: 111-119
- Magnetic resonance imaging for the detection, localisation, and characterisation of prostate cancer: recommendations from a European consensus meeting.Eur Urol. 2011; 59: 477-494
- Using gray-scale and color and power Doppler sonography to detect prostatic cancer.AJR Am J Roentgenol. 2000; 174: 623-627
- Overdiagnosis and overtreatment of prostate cancer.Eur Urol. 2014; 65: 1046-1055
- Prospective assessment of prostate cancer aggressiveness using 3-T diffusion-weighted magnetic resonance imaging-guided biopsies versus a systematic 10-core transrectal ultrasound prostate biopsy cohort.Eur Urol. 2012; 61: 177-184
- Transperineal magnetic resonance image targeted prostate biopsy versus transperineal template prostate biopsy in the detection of clinically significant prostate cancer.J Urol. 2013; 189: 860-866
- Prostate cancer diagnosis: multiparametric MR-targeted biopsy with cognitive and transrectal US-MR fusion guidance versus systematic biopsy--prospective multicenter study.Radiology. 2013; 268: 461-469
- Magnetic resonance imaging/ultrasound fusion guided prostate biopsy improves cancer detection following transrectal ultrasound biopsy and correlates with multiparametric magnetic resonance imaging.J Urol. 2011; 186: 1281-1285
- Prospective evaluation of prostate cancer detected on biopsies 1, 2, 3 and 4: when should we stop?.J Urol. 2001; 166: 1679-1683
- Outcome for repeated biopsy of the prostate: roles of serum PSA, small atypical glands, and prostatic intraepithelial neoplasia.Am J Clin Pathol. 2007; 128: 648-651
- AUA policy statement on the use of multiparametric magnetic resonance imaging in the diagnosis, staging and management of prostate cancer.J Urol. 2017; 198: 832-838
- ACR appropriateness criteria ((R)) prostate cancer-pretreatment detection, surveillance, and staging.J Am Coll Radiol. 2017; 14: S245-S257
- Diagnostic accuracy of multi-parametric MRI and TRUS biopsy in prostate cancer (PROMIS): a paired validating confirmatory study.Lancet. 2017; 389: 815-822
- Targeted biopsy in the detection of prostate cancer using an office based magnetic resonance ultrasound fusion device.J Urol. 2013; 189: 86-91
- Magnetic resonance imaging/ultrasound-fusion biopsy significantly upgrades prostate cancer versus systematic 12-core transrectal ultrasound biopsy.Eur Urol. 2013; 64: 713-719
- Comparison of systematic transrectal biopsy to transperineal magnetic resonance imaging/ultrasound-fusion biopsy for the diagnosis of prostate cancer.BJU Int. 2015; 116: 873-879
- Relationship between prebiopsy multiparametric magnetic resonance imaging (MRI), biopsy indication, and MRI-ultrasound fusion-targeted prostate biopsy outcomes.Eur Urol. 2016; 69: 512-517
- In patients with a previous negative prostate biopsy and a suspicious lesion on magnetic resonance imaging, is a 12-core biopsy still necessary in addition to a targeted biopsy?.BJU Int. 2015; 115: 562-570
- Value of targeted prostate biopsy using magnetic resonance-ultrasound fusion in men with prior negative biopsy and elevated prostate-specific antigen.Eur Urol. 2014; 65: 809-815
- Recent advances in image-guided targeted prostate biopsy.Abdom Imaging. 2015; 40: 1788-1799
- Current status of magnetic resonance imaging (MRI) and ultrasonography fusion software platforms for guidance of prostate biopsies.BJU Int. 2014; 114: 641-652
Article Info
Publication History
Published online: September 22, 2018
Accepted:
September 18,
2018
Received in revised form:
September 6,
2018
Received:
April 17,
2018
Footnotes
☆This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology ( NRF-2013R1A1A2011398 ).
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
