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BJU Int. 2015 Jan;115(1):50-7. doi: 10.1111/bju.12690. Epub 2014 Jul 27.

First round of targeted biopsies using magnetic resonance imaging/ultrasonography fusion compared with conventional transrectal ultrasonography-guided biopsies for the diagnosis of localised prostate cancer.

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Academic Department of Urology, AP-HP, Hopital Pitié-Salpétrière, Paris, France; UPMC University of Paris 06, Institut des Systèmes Intelligents et de Robotique.



To assess the accuracy of magnetic resonance imaging (MRI)/transrectal ultrasonography (TRUS) fusion to guide first-round biopsies in the diagnosis of localised prostate cancer (PCa) in men with a prostate-specific antigen (PSA) ≤10 ng/mL.


A prospective study was conducted on men who met the following criteria: first-round biopsy, multiparametric MRI (mpMRI) showing a lesion with a Likert score ≥2 and a PSA <10 ng/mL. All men underwent a extended 12-core protocol plus a protocol of two or three targeted cores on the mpMRI index lesion. The UroStation (Koelis, Grenoble, France) and a V10 ultrasound system with an end-fire three-dimensional TRUS transducer were used for the fusion imaging procedure. Significant PCa was defined as: at least one core with a Gleason score of 3 + 4 or 6 with a maximum cancer core length ≥4 mm.


A total of 152 men, whose median PSA level was 6 ng/mL, were included in the study. The proportion of positive cores was significantly higher with the targeted-core protocol than with the extended 12-core protocol (P < 0.001). The proportion of men with clinically significant PCa was higher with the targeted-core protocol than with the extended 12-core protocol (P = 0.03). The proportion of patients having at least one positive biopsy (targeted-core protocol) was significantly different among the Likert score categories (P < 0.001).


For the first round of biopsies, MRI/TRUS-fusion targeted biopsies detected more men with clinically significant PCa than did standard extended 12-core biopsy alone.


Gleason score; MRI; biopsy; prostate neoplasms; prostate-specific antigen

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