MP11-08 MANUALLY CONTROLLED TARGETED BIOPSY WITH REAL-TIME FUSION IMAGE OF MULTIPARAMETRIC MAGNETIC RESONANCE IMAGE AND TRANSRECTAL ULTRASOUND IMAGE FOR THE DIAGNOSIS OF PROSTATE CANCER BASED ON PROSTATE IMAGE-REPORTING AND DATA SYSTEM

Abstract

You have accessJournal of UrologyImaging/Radiology: Uroradiology II1 Apr 2015MP11-08 MANUALLY CONTROLLED TARGETED BIOPSY WITH REAL-TIME FUSION IMAGE OF MULTIPARAMETRIC MAGNETIC RESONANCE IMAGE AND TRANSRECTAL ULTRASOUND IMAGE FOR THE DIAGNOSIS OF PROSTATE CANCER BASED ON PROSTATE IMAGE-REPORTING AND DATA SYSTEM Sunao Shoji, Shinichiro Hiraiwa, Akio Hashimoto, Kazunobu Hashida, Jun Endo, Tetsuro Tomonaga, Mayura Nakano, Takuma Tajiri, Toshiro Terachi, and Toyoaki Uchida Sunao ShojiSunao Shoji More articles by this author , Shinichiro HiraiwaShinichiro Hiraiwa More articles by this author , Akio HashimotoAkio Hashimoto More articles by this author , Kazunobu HashidaKazunobu Hashida More articles by this author , Jun EndoJun Endo More articles by this author , Tetsuro TomonagaTetsuro Tomonaga More articles by this author , Mayura NakanoMayura Nakano More articles by this author , Takuma TajiriTakuma Tajiri More articles by this author , Toshiro TerachiToshiro Terachi More articles by this author , and Toyoaki UchidaToyoaki Uchida More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.389AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To report clinical results of manually controlled targeted biopsy with real-time multiparametric magnetic resonance image (mpMRI)-transrectal ultrasound (TRUS) fusion images for the diagnosis of prostate cancer based on prostate image-reporting and data system (PI-RAD). METHODS The patients with PSA level greater than 4.0 ng/ml and less than 20 ng/ml were performed mpMRI prospectively. All mpMRI images including T2WI, dynamic, DWI, and ADC map (Fig 1a). We performed targeted biopsies for each cancer-suspicious lesion and 12 systematic biopsies using the BioJet® (GeoScan, Lakewood Ranch, USA). Using the interactive needle guide system in the deivce, the biopsy template coordinates were shown on the monitor when the operator marked the target point of the region of interest (ROI) (Fig 1b) on the workstation. The operator inserted the needle at the template coordinates, and could get the prostate specimens by viewing the sagittal image of the prostate (Fig 1c). Pathological findings of targeted and systematic biopsies were analyzed. RESULTS Eighty one patients were included in this study. Median age of the patients was 69 years. Median preoperative PSA value was 6.8 ng/ml. Median preoperative prostate volume was 36 ml. The number of the cancer-detected cases was 45 (56%). Positive core length (p = 0.004), positive core percent (p < 0.0001), and Gleason score (p = 0.006) were also significantly different between targeted and systematic biopsies. Cancer detection rate of the patients with PI-RAD classification of 5 in TZ and PZ were 50% and 95%, respectively (p<0.0001). In 15 patients who underwent radical prostatectomy, the geographic locations and pathological grades of clinically significant cancers corresponded to the pathological results of the targeted biopsies. CONCLUSIONS The cancers detected by targeted biopsies with the present biopsy method had significantly higher grades and larger volumes length compared with those detected by the systematic biopsies. Further studies and the comparison to the pathological findings of whole-gland have potential to give a larger role to the present biopsy in areas such as patient selection of focal therapy and active surveillance. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e122 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Sunao Shoji More articles by this author Shinichiro Hiraiwa More articles by this author Akio Hashimoto More articles by this author Kazunobu Hashida More articles by this author Jun Endo More articles by this author Tetsuro Tomonaga More articles by this author Mayura Nakano More articles by this author Takuma Tajiri More articles by this author Toshiro Terachi More articles by this author Toyoaki Uchida More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...