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World J Urol. 2015 Nov;33(11):1707-14. doi: 10.1007/s00345-015-1525-4. Epub 2015 Mar 14.

Targeted MRI/TRUS fusion-guided biopsy in men with previous prostate biopsies using a novel registration software and multiparametric MRI PI-RADS scores: first results.

Author information

1
Institute for Radiology, Hannover Medical School, Carl-Neuberg Str. 1, 30625, Hannover, Germany. Tewes.Susanne@mh-hannover.de.
2
Institute for Radiology, Hannover Medical School, Carl-Neuberg Str. 1, 30625, Hannover, Germany.
3
Department of Urology and Urologic Oncology, Hannover Medical School, Carl-Neuberg Str. 1, 30625, Hannover, Germany.

Abstract

PURPOSE:

To evaluate a novel system for MRI/TRUS fusion-guided biopsy for detection of prostate cancer (PCa) in patients with previous negative prostate biopsy and determine diagnostic accuracy when using the Prostate Imaging Reporting and Data System (PI-RADS) for multiparametric magnetic resonance imaging (mpMRI) as proposed by the European Society of Urogenital Radiology.

METHODS:

Thirty-nine men with clinical suspicion of PCa and history of previous prostate biopsy underwent mpMRI on a 3-T MRI. In total, 72 lesions were evaluated by the consensus of two radiologists. PI-RADS scores for each MRI sequence, the sum of the PI-RADS scores and the global PI-RADS were determined. MRI/TRUS fusion-guided targeted biopsy was performed using the BioJet™ software combined with a transrectal ultrasound system. Image fusion was based on rigid registration. PI-RADS scores of the dominant lesion were compared with histopathological results. Diagnostic accuracy was determined using receiver operating characteristic curve analysis.

RESULTS:

MRI/TRUS fusion-guided biopsy was reliable and successful for 71 out of 72 lesions. The global PI-RADS score of the dominant lesion was significantly higher in patients with PCa (4.0 ± 1.3) compared to patients with negative histopathology (2.6 ± 0.8; p = 0.0006). Using a global PI-RADS score cut-off ≥4, a sensitivity of 85 %, a specificity of 82 % and a negative predictive value of 92 % were achieved.

CONCLUSIONS:

The described fusion system is dependable and efficient for targeted MRI/TRUS fusion-guided biopsy. mpMRI PI-RADS scores combined with a novel real-time MRI/TRUS fusion system facilitate sufficient diagnosis of PCa with high sensitivity and specificity.

KEYWORDS:

MRI/TRUS fusion-guided biopsy; Multiparametric MRI; PI-RADS scoring; Prostate cancer

PMID:
25774003
DOI:
10.1007/s00345-015-1525-4
[Indexed for MEDLINE]

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