Early experience with multiparametric magnetic resonance imaging-targeted biopsies under visual transrectal ultrasound guidance in patients suspicious for prostate cancer undergoing repeated biopsy. (February 2015)

• Record Type: Journal Article
• Authors: Boesen, Lars; Noergaard, Nis; Chabanova, Elizaveta; Logager, Vibeke; Balslev, Ingegerd; Mikines, Kari; Thomsen, Henrik S.
• Is Part Of: Scandinavian journal of urology. Volume 49:Number 1(2015:Feb.)
• Page Start: 25
• Page End: 34
• Publication Date: 2015-02
• Subjects: Urology -- Periodicals; 616.6
• DOI: 10.3109/21681805.2014.925497
• Languages: English
• ISSNs: 2168-1805

Abstract

<abstract> <title>Abstract</title> <p> <bold> <italic>Objectives.</italic> </bold> The purpose of this study was to investigate the detection rate of prostate cancer (PCa) by multiparametric magnetic resonance imaging-targeted biopsies (mp-MRI-bx) in patients with prior negative transrectal ultrasound biopsy (TRUS-bx) sessions without previous experience of this. <italic>Material and methods.</italic> Eighty-three patients with prior negative TRUS-bx scheduled for repeated biopsies due to persistent suspicion of PCa were prospectively enrolled. mp-MRI was performed before biopsy and all lesions were scored according to the Prostate Imaging Reporting and Data System (PI-RADS) and Likert classification. All underwent repeated TRUS-bx (10 cores) and mp-MRI-bx under visual TRUS guidance of any mp-MRI-suspicious lesion not targeted by systematic TRUS-bx. <italic>Results.</italic>PCa was found in 39 out of 83 patients (47%) and mp-MRI identified at least one lesion with some degree of suspicion in all 39 patients. Both PI-RADS and Likert scoring showed a high correlation between suspicion of malignancy and biopsy results (<italic>p</italic> < 0.0001). Five patients (13%) had cancer detected only on mp-MRI-bx outside the TRUS-bx areas (<italic>p</italic> = 0.025) and another seven patients (21%) had an overall Gleason score upgrade of at least one grade based on the mp-MRI-bx. Secondary PCa lesions not visible on mp-MRI were detected by TRUS-bx in six out of 39 PCa patients. The secondary foci were all Gleason 6 (3 + 3) in 5–10% of the biopsy core. According to the Epstein criteria, 37 out of 39 cancer patients were classified as clinically significant. <italic>Conclusion.</italic> Using mp-MRI, even without previous experience, can improve the detection rate of significant PCa at repeated biopsy and allows more accurate Gleason grading.</p> </abstract>