The value of transrectal ultrasound and magnetic resonance imaging fusion targeted prostate biopsy in biopsy-naive men

Abstract

Objective To estimate the value of transrectal ultrasound/magnetic resonance imaging(TRUS/MR) fusion targeted prostate biopsy(targeted biopsy, TB) in the biopsy naive patients. Methods Between September 2015 and September 2016, 91 patients with PI-RADS ≥3 suspicious regions on the multiparametric magnetic resonance imaging (mpMRI) were retrospectively evaluated. The age of patients was 46-83 years (median 68). Serum PSA level before biopsy was 1.2-85 ng/ml (median 11.2 ng/ml), in which 36 cases with PSA 20 ng/ml. Two-core TB using real-time virtual sonography (RVS) platform for mpMRI-suspicious lesions was followed by 12-core systematic biopsy (SB). The detection rates for any cancer (PCa) and clinically significant prostate cancer (CsPCa) were compared between TB and SB. Results The total detection rate for PCa was 57.1%, with a comparable positive rate between TB (44.0%) and SB (51.7%) groups which did not significantly differ (P=0.14). The proportion of CsPCa in TB group was higher than that in SB group (80.0% vs. 68.1%, P=0.21). In TB group, detection of PCa for grade 5 lesions was significantly higher than that for grade 3 lesions (77.1% vs. 10.3%, P 20ng/ml (27.8% vs. 36.1%, 50% vs. 56.7%, 60% vs. 68%, respectively). Conclusions This study revealed a similar rate of prostate cancer detection between 2-core targeted biopsy guided by TRUS/MR fusion and 12-core random biopsy in different PSA regions for no prior biopsy men. TB maybe tend to detect high proportion of CsPCa. PI-RADS is instructive to select appropriate patients for TB. Key words: Prostate biopsy; Prostatic neoplasms; Transrectal ultrasound and magnetic resonance imaging fusion(TRUS/MR)