Aims and objectives
Current guidelines recommend a 12-core systematic biopsy following the finding of an elevated serum prostate-specific antigen (PSA).
The shortcomings of standart systematic transrectal ultrasound guided biopsy,
including false-negative rates,
detection of clinically insignificant disease requires the optimization of prostate biopsy technique.
Magnetic resonance imaging is noninvasive imaging modality that increases the accurate localization proctate cancer.
Multiparametric MRI/US-fusion guided biopsy is the procedure,
in which prebiopsy MRI of the prostate is registered and fused with real-time ultrasound using electromagnetic tracking and a digital overlay.
Methods and materials
Subjects were enrolled in a prospective trial assessing MRI/US-fusion guided prostate at the P.A.
Herzen Moscow Oncology Research Institute between May 2014 and September 2014.
During the study period,
a total of 14 MRI/US-fusion guided prostate biopsies were performed,
including 12 patients with repeated biopsies on active surveillance.
Patient demographics and prebiopsy prostate-specific antigen (PSA) level,
number of MP-MRI lesions,
and MP-MRI cancer-suspicion score per lesion were noted.
Patient demographics of the study cohort are shown in Table 1.
The mean age of the patient...
PCa was found in 11out of 14 patients (78,6%) four patients (28,5%) had cancer detected only on MRI/US-fusion outside the TRUS prostate biopsies areas.
PCa lesions were visible on mp-MRI and also were detected by TRUS biopsies in seven out of 14 patients (50%).
All patients was divided into clinically significant high-grade (Gleason score ≥4+3) and clinically insignificant low-grade (Gleason score ≤3+4) subcohorts.
A distribution of Gleason score on standard 12-core biopsy versus MRI/US-fusion guided biopsy can be seen in Table 2.
Table 2 Comparison...
This study highlights a potentially useful role of MRI/US-fusion guided targeted biopsies for the identification of tumors otherwise missed by 12-core biopsy alone.
Our own experience for present time is too small to talk about sensitivity,
but it should be noted that using MRI/US-fusion guided biopsy allowed to increase detectability of prostate cancer in 14,3% cases and could reduce the quantity of prostate cores at 64,3% patients,
make the procedure less injuring.
Multiparametric 3T prostate magnetic resonance imaging to detect cancer: histopathological correlation using prostatectomy specimens processed in customized magnetic resonance imaging based molds.
PI-RADS classification:structured reporting for MRI the prostate.