PD06-02 MANUALLY CONTROLLED TRANS-PERINEAL TARGETED BIOPSY WITH REAL-TIME FUSION IMAGE OF MULTI-PARAMETRIC MAGNETIC RESONANCE IMAGE AND TRANS-RECTAL ULTRASOUND IMAGE FOR THE DIAGNOSIS OF PROSTATE SIGNIFICANT CANCER BASED ON PROSTATE IMAGE-REPORTING AND DATA SYSTEM VERSION 1

Abstract

You have accessJournal of UrologyImaging/Radiology: Uroradiology II1 Apr 2016PD06-02 MANUALLY CONTROLLED TRANS-PERINEAL TARGETED BIOPSY WITH REAL-TIME FUSION IMAGE OF MULTI-PARAMETRIC MAGNETIC RESONANCE IMAGE AND TRANS-RECTAL ULTRASOUND IMAGE FOR THE DIAGNOSIS OF PROSTATE SIGNIFICANT CANCER BASED ON PROSTATE IMAGE-REPORTING AND DATA SYSTEM VERSION 1 Sunao Shoji, Taro Higure, Masayoshi Kawakami, Mayura Nakano, Toshiro Terachi, and Toyoaki Uchida Sunao ShojiSunao Shoji More articles by this author , Taro HigureTaro Higure More articles by this author , Masayoshi KawakamiMasayoshi Kawakami More articles by this author , Mayura NakanoMayura Nakano 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.2016.02.2622AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To report clinical results of manually controlled targeted trans-perineal biopsy with real-time fusion image of multi-parametric magnetic resonance image (mpMRI)-trans-rectal ultrasound (TRUS) for the diagnosis of prostate significant cancer based on prostate image-reporting and data system version 1 (PI-RAD v1). METHODS The patients with PSA level less than 20 ng/ml were performed mpMRI prospectively. All mpMRI images including T2WI, dynamic, DWI, and ADC map. We performed trans-perineal targeted biopsies for each cancer-suspicious lesion and 12-cores systematic biopsies using the BioJet® (D&K Technologies GmbH, Barum, Germany). Three-dimensional prostate models were reconstructed with MRI, TRUS images, and biopsy results (Fig 1a). The relationships between mpMRI finding, biopsy pathological findings and whole-mount prostate specimen (Fig 1b) were analyzed. RESULTS Two hundred patients were included in this study. Median age of the patients was 67 years (range: 50 to 89 years). Median preoperative PSA value was 6.9 ng/ml (range: 3.54 to 20.0). Median preoperative prostate volume was 35 ml (range: 22 to 68). We detected 118 cancers (59%), with a median Gleason score of 7 (range: 6 to 9). Detection rates of targeted areas with PI-RAD classification 4 and 5 in the transition zone (TZ) and the peripheral zone (PZ) were 24% and 88% in classification 4 and 56% and 97% in classification 5, respectively. Cancer detection rate (p<0.0001), 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. In 27 patients who underwent radical prostatectomy, geographic locations and pathological grades of significant cancers (n=37) in whole-mount prostate specimens corresponded to the pathological results of the targeted biopsies. CONCLUSIONS The present targeted biopsy method was superior to 12-cores systematic biopsy, and clinically significant cancers with a spatial relationship were detected accurately in the present study. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e174 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Sunao Shoji More articles by this author Taro Higure More articles by this author Masayoshi Kawakami More articles by this author Mayura Nakano 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 ...