Korean J Urol Oncol.  2018 Aug;16(2):63-68. 10.22465/kjuo.2018.16.2.63.

A Study on the Complications and Pathologic Results of the Patients Undergoing Magnetic Resonance Imaging Guided Prostate Biopsy

Affiliations
  • 1Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea. sclee@snubh.org

Abstract

PURPOSE
We aimed to study clinicopathological parameters and complications of patients who underwent magnetic resonance imaging-transrectal ultrasonography fusion guided prostate biopsy (MRI-TRUS FGB).
MATERIALS AND METHODS
We investigated 576 patients who underwent MRI-TRUS FGB of prostate from May 2003 to December 2017 retrospectively. The clinicopathological features and complications were presented, using the modified Clavien-Dindo classification system.
RESULTS
Fourteen patients (2.4%) readmitted within 30 days after MRI-TRUS FGB due to complications, and 85.7% (12 of 14) of them complained mild to moderate complications, the Clavien-Dindo classification grades I and II. The most common complication was hematuria (n=5, 0.9%), followed by acute urinary retention (n=3, 0.5%), dysuria (n=2, 0.3%), fever (n=1, 0.2%), hematochezia (n=1, 0.2%). According to multivariate analysis, only age was the significant risk factor of overall complications and bleeding related complications. Two hundred thirteen patients were diagnosed as prostate cancer after MRI-TRUS FGB. When the Likert suspicious scale of prostate cancer on apparent diffusion coefficient (ADC) was ≤4, 27.8% (137 of 493) were diagnosed as prostate cancer, of whom 56.2% (77 of 137) were confirmed as prostate cancer only at randomized 12 cores. When the ADC suspicious level was grade 5, 91.6% (76 of 83) were diagnosed as prostate cancer, of whom 11.8% (7 of 76) were confirmed as prostate cancer only at randomized 12 cores.
CONCLUSIONS
The present study demonstrates the safety of MRI-TRUS FGB in terms of complications. When ADC suspicious level is grade 5, MRI-TRUS FGB alone could be a reasonable measure to diagnose prostate cancer, but randomized 12-core prostate biopsy would be recommended additionally when ADC suspicious level is ≤4.

Keyword

Prostate; Prostate biopsy; Magnetic resonance imaging; Complication; Pathology

MeSH Terms

Biopsy*
Classification
Diffusion
Dysuria
Fever
Gastrointestinal Hemorrhage
Hematuria
Hemorrhage
Humans
Magnetic Resonance Imaging*
Multivariate Analysis
Pathology
Prostate*
Prostatic Neoplasms
Retrospective Studies
Risk Factors
Ultrasonography
Urinary Retention
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