In detection of prostate cancer,
transrectal ultrasound (TRUS) guided random biopsy is the “gold standard” in patients with high values of PSA (Prostatic Specific Antigen).
A new technique using MRI and US fusion imaging was considered by our institution to perform accurate targeted biopsies in highly suspicious areas of the peripheral prostate gland observed after MRI exam.
The aim of this study is to improve the accuracy of targeted biopsies and to increase the detection of prostatic cancer in patients with high PSA,...
Methods and Materials
Imaging findigs OR procedure details
In our study we decided to perform MRI to patients that had previously negative DRE,
negative TRUS random biopsy and high PSA values.
The MRI examination included sequences for study of general pelvis and special sequences for the study of prostate gland as T2 weighted high resolution sequences [Fig 4],
diffusion weighted imaging [Fig 5]and perfusion technique.
that were highlighted on axial T2 weighted images,
were classified as high,
moderate or low degree of cancer risk.
In our initial experience,
using MRI and US image fusion technique,
6/15 patients were diagnosed with prostate cancer.
Each lesion was categorized by multiparametric MRI in high,
medium and low risk.
When MRI lesion has been marked as highly suspicious,
the detection rate was 100% (4/4); medium 33% (2/6) and low 0% (0/5).
In only one patientprostatic cancer in the same lobe was found both in targeted and in random biopsy.
In the latest case the target specimen had the highest Gleason score (3+4) versus...
The high sensibility of targeted biopsies,
using MRI and US image fusion technique in those patients,who have had a prior negative biopsy,might be an accurate method in detection of prostate cancer.
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Ospedale San Bartolomeo,
Via Cisa 19038,
Università degli studi di Genova,
Ospedale San Martino,
Largo Rosanna Benzi 10,