Abstract
ABSTRACT Objective MRI of the prostate improves diagnostic accuracy of prostate cancer. Different fusion approaches with transrectal ultrasound images are employed.Objective To determine detection rate of prostate cancer in men undergoing transperineal MRI-based cognitive fusion biopsy.Materials and Methods One hundred and sixty-four consecutive men underwent a multiple-core prostate transperineal biopsy. Univariable and multivariable logistic regression analyses were used to address the relationship between clinical parameters and prostate cancer detection rate.Results One hundred and fourteen patients underwent mpMRI prior to the transperineal biopsy, 52 (45%) were diagnosed with prostate cancer, of them, 36 had Gleason score ≥7 (69%). Among these 114 patients, 82 had suspicious lesions on MRI, and 43 of them were diagnosed with cancer (52%). On multivariate analysis, the most significant independent predictive factors were PSA density (P<0.001) and suspicious MRI lesion (P=0.006). Men with a PSA density of more than 0.22 and a suspicious lesion on MRI had a detection rate of 78%. Detection rate among 50 patients with no MRI study prior to this biopsy was 26%.Conclusions This study showed that among a group of mostly multi-biopsied patients, the presence of mpMRI lesions and high PSA density values helped to detect clinically significant prostate cancer using cognitive MRI/TRUS fusion biopsies.
Highlights
Tools to enhance accurate detection of clinically significant prostate cancer are frequently developed
The prostate gland was scanned from the level of the proximal seminal vesicles/base of the prostate gland to the apex and prostate volume was determined and the region of interest was projected according to the MRI study
All 164 consecutive men who had transperineal template-guided biopsy were included in the study
Summary
Tools to enhance accurate detection of clinically significant prostate cancer are frequently developed These tools are supposed to help avoiding the shortcomings of conventional biopsy such as false-negative results or under diagnosis of aggressive cancer as well as overdiagnosis of insignificant disease. Bott et al [4, 5] developed the brachytherapy template-guided transperineal technique, which increased the detection rate of significant tumors located especially in the anterior zone of the prostate gland. This procedure still has a role in defining disease previously missed or under-diagnosed [6]. It seems most would agree that the transperineal approach ibju | cognitive fusion prostate biopsies enables the examiner to get samples from prostate areas that are difficult, if not impossible, to sample by the transrectal approach [7]
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