Investig Clin Urol.  2019 May;60(3):156-161. 10.4111/icu.2019.60.3.156.

Multiparametric magnetic resonance imaging-transrectal ultrasound fusion biopsies increase the rate of cancer detection in populations with a low incidence of prostate cancer

• Kaushal R
• Das CJ
• Singh P
• Dogra PN
• Kumar R

• KMID: 2444269
• DOI: http://doi.org/10.4111/icu.2019.60.3.156

Abstract

PURPOSE
To prospectively evaluate the diagnostic yield of multiparametric magnetic resonance imaging (mpMRI)-fusion, transrectal ultrasound (TRUS)-guided prostate biopsies for detection of prostate cancer in an Asian population with a low incidence of prostate cancer.
MATERIALS AND METHODS
A total of 131 males with suspected prostate cancer were recruited to undergo fusion biopsy with the Artemis prostate fusion biopsy device (Eigen, Grass Valley, CA, USA). All patients underwent standard 12-core systematic biopsies in addition to biopsies targeted at the mpMRI-identified abnormal regions. Yield from the standard cores was compared with that from the targeted cores. Gleason scores of 4+3 or higher were considered significant.
RESULTS
The mean age of the patients was 63.54±7.96 years and the mean prostate-specific antigen value was 9.75±5.35 ng/mL. A total of 36 patients had cancer, of which 3 (8.3%) were detected only on standard cores and 3 (8.3%) only on targeted cores. Of the clinically significant cancers (n=30), targeted biopsy detected a higher number (28/30, 93.3%) than standard biopsy (21/30, 70.0%). A total of 6 of 8 cancers (75.0%) that were insignificant on standard biopsy were upgraded to significant cancer on targeted cores.
CONCLUSIONS
Eight percent of cancers were detected only on MRI-TRUS fusion-targeted biopsies, whereas the method upgraded more than two-thirds of insignificant cancers to significant cancers. Fusion biopsies thus provide incremental information over standard TRUS biopsies in the diagnosis of significant prostate cancer in populations with a low incidence of prostate cancer.

Keyword

Biopsy; Magnetic resonance imaging; Prostatic neoplasms

MeSH Terms

Asian Continental Ancestry Group
Biopsy*
Diagnosis
Humans
Incidence*
Magnetic Resonance Imaging
Male
Methods
Poaceae
Prospective Studies
Prostate*
Prostate-Specific Antigen
Prostatic Neoplasms*
Ultrasonography*
Prostate-Specific Antigen

Figure

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  Fig. 1 PROFUSE software (Eigen, Grass Valley, CA, USA) for assignment of region of interest.

• 

  Fig. 2 Needle tracking of each core biopsied.

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