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World J Urol. 2017 Dec;35(12):1849-1855. doi: 10.1007/s00345-017-2085-6. Epub 2017 Sep 4.

Retrospective comparison of direct in-bore magnetic resonance imaging (MRI)-guided biopsy and fusion-guided biopsy in patients with MRI lesions which are likely or highly likely to be clinically significant prostate cancer.

Author information

1
Department of Radiology and Nuclear Medicine, Radboud University Medical Center, P.O.Box 9101, 6500 HB, Nijmegen, The Netherlands. Wulphert.Venderink@radboudumc.nl.
2
Department of Radiology and Nuclear Medicine, Radboud University Medical Center, P.O.Box 9101, 6500 HB, Nijmegen, The Netherlands.
3
Department of Urology, Radboud University Medical Center, Nijmegen, The Netherlands.

Abstract

PURPOSE:

To compare clinically significant prostate cancer (csPCa) detection rates between magnetic resonance imaging (MRI)-transrectal ultrasound (TRUS) fusion-guided prostate biopsy (FGB) and direct in-bore MRI-guided biopsy (MRGB).

METHODS:

We performed a comparison of csPCa detection rates between FGB and MRGB. Included patients had (1) at least one prior negative TRUS biopsy; (2) a Prostate Imaging Reporting and Data System (PI-RADS) 4 or 5 lesion and (3) a lesion size of ≥8 mm measured in at least one direction. We considered a Gleason score ≥7 being csPCa. Descriptive statistics with 95% confidence intervals (CI) were used to determine any differences.

RESULTS:

We included 51 patients with FGB (59 PI-RADS 4 and 41% PI-RADS 5) and 227 patients with MRGB (34 PI-RADS 4 and 66% PI-RADS 5). Included patients had a median age of 69 years (IQR, 65-72) and a median PSA level of 11.0 ng/ml (IQR, 7.4-15.1) and a median age of 67 years (IQR, 61-70), the median PSA 12.8 ng/ml (IQR, 9.1-19.0) within the FGB and the MRGB group, respectively. Detection rates of csPCA did not differ significantly between FGB and MRGB, 49 vs. 61%, respectively.

CONCLUSION:

We did not detect significant differences between FGB and MRGB in the detection of csPCa. The differences in detection ratios between both biopsy techniques are narrow with an increasing lesion size. This study warrants further studies to optimize selection of best biopsy modality.

KEYWORDS:

Biopsy; Detection rate; Direct in-bore; MRI-TRUS fusion; PI-RADS; Prostate

PMID:
28871396
PMCID:
PMC5693982
DOI:
10.1007/s00345-017-2085-6
[Indexed for MEDLINE]
Free PMC Article

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