Reply by the Authors

Abstract

We appreciate the authors' interest in our article and strongly agree that the increased utilization of multiparametric MRI (mpMRI) of the prostate has led to important clinical questions. Our study results are consistent with those of other large institutional outcomes, as well as trials such as PROFUS, which show the superiority in cancer detection of MR-targeted biopsies compared with standard transrectal ultrasound-guided biopsy. 1 Wysock J.S. Rosenkrantz A.B. Huang W.C. et al. A prospective, blinded comparison of magnetic resonance (MR) imaging-ultrasound fusion and visual estimation in the performance of MR-targeted prostate biopsy: the PROFUS trial. Eur Urol. 2014; 66: 343-351 Abstract Full Text Full Text PDF PubMed Scopus (300) Google Scholar In our study, the overall cancer detection rate was significantly higher in the MR-ultrasound (US) fusion biopsy cohort than in both cognitive and standard transrectal ultrasound-guided biopsy, yet there was no significant difference in detection of clinically significant prostate cancer between MR-US fusion biopsy and cognitive biopsy. It is important to recognize that our primary end point was the overall detection of cancer, and our study was likely underpowered to detect a difference in “clinically significant” cancer. Despite this, there was a strong trend toward improved detection of Gleason 7 and higher cancer in the fusion cohort: 29.6% (24 of 81) of MR-US fusion biopsies detected clinically significant cancer vs 16.5% (25 of 150) of biopsies with cognitive targeted biopsy (COG-TB) biopsies (P = .07). Pathologic Risk Factors for Metastatic Disease in Postpubertal Patients With Clinical Stage I Testicular Stromal TumorsUrologyVol. 97PreviewTo systematically review the existing literature to analyze the impact of previously identified pathologic risk factors on harboring occult metastatic disease (OMD) in patients with Clinical Stage I testicular stromal tumors (TSTs). Full-Text PDF Re: Oberlin et al.: Diagnostic Value of Guided Biopsies: Fusion and Cognitive-registration Magnetic Resonance Imaging Versus Conventional Ultrasound Biopsy of the Prostate (Urology 2016;92:75-79)UrologyVol. 110PreviewWe have read with great interest the study entitled “Diagnostic Value of Guided Biopsies: Fusion and Cognitive-registration Magnetic Resonance Imaging Versus Conventional Ultrasound Biopsy of the Prostate” by Oberlin et al.1 The authors compared prostate cancer detection rates among men undergoing magnetic resonance-ultrasound (MR-US) fusion biopsy, cognitive targeted biopsy (COG-TB), and conventional transrectal ultrasound-guided biopsy. The authors concluded that the overall prostate cancer detection rate was significantly higher in the MR-US fusion biopsy cohort than in both COG-TB and transrectal ultrasound-guided biopsy. Full-Text PDF