MP48-19 COGNITIVE MRI-ECHO FUSION BIOPSY OF THE PROSTATE IS A VALUABLE FIRST STEP IN DIAGNOSING PROSTATE CANCER

Abstract

You have accessJournal of UrologyProstate Cancer: Detection and Screening I1 Apr 2015MP48-19 COGNITIVE MRI-ECHO FUSION BIOPSY OF THE PROSTATE IS A VALUABLE FIRST STEP IN DIAGNOSING PROSTATE CANCER Paul Westerveld, Jessica Vriesema, Huib van den Hout, Jeroen Veltman, and Erik Cornel Paul WesterveldPaul Westerveld More articles by this author , Jessica VriesemaJessica Vriesema More articles by this author , Huib van den HoutHuib van den Hout More articles by this author , Jeroen VeltmanJeroen Veltman More articles by this author , and Erik CornelErik Cornel More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1693AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Multiparimetric magnetic resonance imaging (MRI) of the prostate is increasingly used for detection and staging of prostate cancer. Significant lesions detected on prostate-MRI need to be evaluated by histological biopsy. MRI guided biopsies are limitedly available, time consuming, uncomfortable and costly. Trans rectal ultrasound (TRUS) guided target biopsies based on MRI findings are a more logical first diagnostic step. Our purpose was to evaluate the performance of cognitive target MRI-TRUS fusion biopsies of MRI detected PI-RADS (Prostate Imaging Reporting and Data System) 4 and 5 lesions. The correlation between the apparent diffusion coefficient (ADC) and Gleason outcome was also studied. METHODS 52 consecutive patients in the period from 12/2013-06/2014 with increased PSA and PI-RADS 4 or 5 lesions on MRI (3T Siemens-skyra, protocol and reporting according to ESUR guidelines) were included. All patients underwent target biopsies using TRUS (B&K, Falcon 2101) which were performed by the same urologist and radiologist with MRI images and structured report available. In patients with a negative biopsy, MRI-guided biopsy was advised. A bi-variate pearson correlation was performed for ADC and Gleason outcome in positive cases. RESULTS A total of 52 patients were included (16 PIRADS 4 and 36 PIRADS 5 lesions). Mean PSA and PSA-density value was respectively 9,88 (SD 6,1) and 0.20 (SD 0.11). Mean lesion size was 13.95 mm (SD 6.26 mm). 9 PIRADS 4 lesions (56%) and 26 PIRADS 5 lesions (72%) were found positive for prostate cancer. The correlation between the ADC value and histology outcome is showed in figure 1. Overall 67% of the biopsies were positive for prostate cancer using cognitive target MRI-TRUS fusion biopsies. The additional MRI-guided-biopsies that were performed from the negative cases proved in 50% to be malignant (0/2 for PI-RADS 4 and 3/4 for PI-RADS 5 lesions). A significant correlation between ADC and Gleason value was found (-0.363 P<0.01) CONCLUSIONS Cognitive target MRI-TRUS fusion biopsies are an effective first step in the evaluation of PIRADS 4 and 5 MRI detected lesions. Additional MRI-Guided-Biopsies of negative results for at least PIRADS 5 lesions are mandatory. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e601-e602 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Paul Westerveld More articles by this author Jessica Vriesema More articles by this author Huib van den Hout More articles by this author Jeroen Veltman More articles by this author Erik Cornel More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...