One-stop prostate imaging: multiparametric-MRI followed by TRUS-guided biopsy

Abstract

Purpose The current role of prostate cancer imaging is to provide biopsy guidance and staging. Previously, magnetic resonance imaging (MRI) was used to pre-assess patients for radical therapy. Recently, multiparametric MRI (MP-MRI) has helped transform the diagnostic pathway through an improved yield in detecting and characterising cancer and is used prior to biopsy in many centres. At our centre, we have recently provided a one-stop same day service of MP-MRI to transrectal ultrasound (TRUS) for pre-selected patients. We investigate whether this service leads to a reduced time to management outcome. Methods and materials Three groups of 20 consecutive patients were identified: TRUS biopsy followed by staging MRI, MP-MRI after TRUS biopsy and the one-stop MP-MRI/TRUS biopsy patients. Date of referral to management outcome decision date was recorded from multi-disciplinary teams (MDT) and clinic letters. Results The mean days of referral to outcome is 75.0, 66.2 and 30.1 days for the TRUS biopsy followed by staging MRI, MP-MRI after TRUS biopsy and one-stop MP-MRI/TRUS biopsy respectively, with the latter group showing less variability. Conclusion A one-stop prostate imaging service in pre-selected patients allows localised staging prior to biopsy, identifies suspicious areas for a targeted biopsy, avoids the pitfalls of post biopsy artefact in MRI interpretation, expedites the MDT process and enhances patient experience. The current role of prostate cancer imaging is to provide biopsy guidance and staging. Previously, magnetic resonance imaging (MRI) was used to pre-assess patients for radical therapy. Recently, multiparametric MRI (MP-MRI) has helped transform the diagnostic pathway through an improved yield in detecting and characterising cancer and is used prior to biopsy in many centres. At our centre, we have recently provided a one-stop same day service of MP-MRI to transrectal ultrasound (TRUS) for pre-selected patients. We investigate whether this service leads to a reduced time to management outcome. Three groups of 20 consecutive patients were identified: TRUS biopsy followed by staging MRI, MP-MRI after TRUS biopsy and the one-stop MP-MRI/TRUS biopsy patients. Date of referral to management outcome decision date was recorded from multi-disciplinary teams (MDT) and clinic letters. The mean days of referral to outcome is 75.0, 66.2 and 30.1 days for the TRUS biopsy followed by staging MRI, MP-MRI after TRUS biopsy and one-stop MP-MRI/TRUS biopsy respectively, with the latter group showing less variability. A one-stop prostate imaging service in pre-selected patients allows localised staging prior to biopsy, identifies suspicious areas for a targeted biopsy, avoids the pitfalls of post biopsy artefact in MRI interpretation, expedites the MDT process and enhances patient experience.