2185 MAGNETIC RESONANCE IMAGING TARGETED PROSTATE BIOPSY WITH 3-DIMENSIONAL ULTRASOUND TRACKING SYSTEM IN COMPARATIVE ANALYSIS TO SYSTEMATIC RANDOM BIOPSY ON 131 CONSECUTIVE PATIENTS WITH PRE-BIOPSY MAGNETIC RESONANCE IMAGING

Abstract

You have accessJournal of UrologyImaging/Radiology: Uroradiology (II)1 Apr 20132185 MAGNETIC RESONANCE IMAGING TARGETED PROSTATE BIOPSY WITH 3-DIMENSIONAL ULTRASOUND TRACKING SYSTEM IN COMPARATIVE ANALYSIS TO SYSTEMATIC RANDOM BIOPSY ON 131 CONSECUTIVE PATIENTS WITH PRE-BIOPSY MAGNETIC RESONANCE IMAGING Osamu Ukimura, Arnaud Marien, Suzanne Palmer, Andre Luis de Castro Abreu, Scott Leslie, Sunao Shoji, Mehrdad Alemozaffar, Anmol Amin, Toru Matsugasumi, Mitchell Gross, Monish Aron, Mihir Desai, and Inderbir Gill Osamu UkimuraOsamu Ukimura Los Angeles, CA More articles by this author , Arnaud MarienArnaud Marien Los Angeles, CA More articles by this author , Suzanne PalmerSuzanne Palmer Los Angeles, CA More articles by this author , Andre Luis de Castro AbreuAndre Luis de Castro Abreu Los Angeles, CA More articles by this author , Scott LeslieScott Leslie Los Angeles, CA More articles by this author , Sunao ShojiSunao Shoji Los Angeles, CA More articles by this author , Mehrdad AlemozaffarMehrdad Alemozaffar Los Angeles, CA More articles by this author , Anmol AminAnmol Amin Los Angeles, CA More articles by this author , Toru MatsugasumiToru Matsugasumi Los Angeles, CA More articles by this author , Mitchell GrossMitchell Gross Los Angeles, CA More articles by this author , Monish AronMonish Aron Los Angeles, CA More articles by this author , Mihir DesaiMihir Desai Los Angeles, CA More articles by this author , and Inderbir GillInderbir Gill Los Angeles, CA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2094AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The aim of this study is to compare the characteristics of the biopsy-proven cancer between magnetic resonance imaging (MRI)-fusion-guided targeted biopsy and transrectal ultrasound (TRUS) systematic random biopsy on the consecutive patients who underwent multi-parametric MRI prior to biopsy. METHODS Between January 2010 and September 2012, 131 consecutive patients underwent both pre-biopsy MRI (T2w-, DWI/ADC, and contrast enhanced MRI using 3 Tesla body-coil) and outpatient TRUS biopsy using the real-time 3-dimensional (3D) TRUS-tracking system (Urostation®, Koelis, France), which enabled MR/US fusion targeted biopsies. It was realized by the same operator. If MRI suggested a concerned focal lesion, 3D volume data of the MRI was elastically fused with TRUS at the time of biopsy. The MRI suggested the concerned focal lesion in 87 of the 131 patients (66.5%). Overall 1483 systematic biopsies (SB) and 255 MRI fusion targeted biopsies (MR-TB) were performed. The mean number of cores per patients was 11.3 for SB and 2.9 for MR-TB for patients who had prior MRI. RESULTS Of the 131 patients the mean age (65 years), PSA (8.15ng/ml), and prostate volume (52 ml). 74 (57%) of the 131 patients had positive biopsy for cancer. In comparison of cancer detection rate per patient: 45% for SB versus 53.4% for MR-TB (p=0.003). In comparison of cancer detection rate per core: only 12.5% (185/1483) of the SB cores versus 43.5% (111/255) for MR-TB (p=0.004). Using a criteria for clinical significant cancer on biopsy defined as Gleason 4+3 or/and cancer core length of 5mm or greater, 34 patients of 46 (70%) were determined as significant cancer by MR-TB whereas only 23 patients (40%) by SB (p=0.031). The median cancer core length (CCL) and the primary Gleason grade (PGG) were significantly higher in patients with MR-TB: CCL=7.51mm [0.5-18] and PGG=3.75 and only CCL=4.12mm [0.3-15] (p=0.00005) and PGG=3.29 for SB (p=0.03). In all cases the spatial location of each biopsy was documented using 3D TRUS-image based tracking technique, to document accurate localization of the biopsy-proven cancer, allowing per-lesion based follow-up. CONCLUSIONS MR-fusion-guided targeted prostate biopsy identifies greater cancer core involvement and higher Gleason grade in comparison to systematic image-blind random biopsies. Image-based targeted biopsy using pre-biopsy MRI and documentation of cancer location would enhance per-lesion based management of prostate cancer. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e896 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Osamu Ukimura Los Angeles, CA More articles by this author Arnaud Marien Los Angeles, CA More articles by this author Suzanne Palmer Los Angeles, CA More articles by this author Andre Luis de Castro Abreu Los Angeles, CA More articles by this author Scott Leslie Los Angeles, CA More articles by this author Sunao Shoji Los Angeles, CA More articles by this author Mehrdad Alemozaffar Los Angeles, CA More articles by this author Anmol Amin Los Angeles, CA More articles by this author Toru Matsugasumi Los Angeles, CA More articles by this author Mitchell Gross Los Angeles, CA More articles by this author Monish Aron Los Angeles, CA More articles by this author Mihir Desai Los Angeles, CA More articles by this author Inderbir Gill Los Angeles, CA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...