MP16-08 MRI-US FUSION IS SUPERIOR TO BOTH COGNITIVE AND RANDOM PROSTATE NEEDLE BIOPSY OF THE PROSTATE

Abstract

You have accessJournal of UrologyProstate Cancer: Detection & Screening I1 Apr 2016MP16-08 MRI-US FUSION IS SUPERIOR TO BOTH COGNITIVE AND RANDOM PROSTATE NEEDLE BIOPSY OF THE PROSTATE Daniel Oberlin, Richard Matulewicz, and Joshua Meeks Daniel OberlinDaniel Oberlin More articles by this author , Richard MatulewiczRichard Matulewicz More articles by this author , and Joshua MeeksJoshua Meeks More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.2573AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Multiparametric MRI of the prostate (mpMRI) is increasingly utilized for the detection of prostate cancer. New technology allows the fusion of prostate US with previously annotated MRI for real-time targeted biopsy. Unfortunately, fusion biopsy is more costly and time-intensive than traditional biopsy. We compared prostate cancer detection rates between a) men undergoing MR-US fusion biopsy, b) mpMRI followed by cognitive registration biopsy, and c) traditional biopsy for the detection of prostate cancer. METHODS Retrospective review of consecutive patients undergoing mpMRI of the prostate with subsequent TRUS-prostate needle biopsy from October 2013 to September 2015 was performed. Concerning lesions seen on mpMRI were targeted with either cognitive registration or MR-US fusion biopsies utilizing the UroNav/Philips-Invivo platform. Rates of cancer detection were compared to a traditional cohort of 100 consecutive men undergoing standard 12-core biopsy. RESULTS A total of 1130 mpMRIs of the prostate were performed, of which 231 patients underwent mpMRI-directed TRUS PNB (81 fusion, 150 cognitive). There was no difference in PSA at the time of biopsy between the three groups (table 1). There was no difference in clinical suspicion for cancer based on mpMRI lesion grade, number of lesions, or history of prostate cancer between cohorts. Significantly more patients in the fusion cohort had had a previous biopsy compared to the other two cohort (36 vs. 13.5%, p<0.001). The overall detection rate for cancer was significantly higher in the fusion cohort (48.1%) compared to both cognitive (34.6% p=0.04) and traditional biopsy (32.0%, p=0.03). The use of MR without fusion biopsy did not improve cancer detection compared to traditional biopsy (34.6% vs. 32%). MR-fusion detected significantly more Gleason grade 7 and higher cancer (29.6 vs. 12%p=0.003) and significantly less Gleason 6 disease (38.4 vs. 62.5%, p=0.04) compared to traditional biopsy. CONCLUSIONS Targeted biopsy of the prostate using MR-US fusion improved the detection rate and pathologic grade of detected cancer compared to both MR-cognitive registration and traditional biopsy. Future research is needed to determine the appropriate clinical utilization of mpMRI for detection of prostate cancer. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e164 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Daniel Oberlin More articles by this author Richard Matulewicz More articles by this author Joshua Meeks More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...