Abstract
Objective:Targeted magnetic resonance/ultrasound fusion prostate biopsy has been shown to improve the detection of high-grade prostate cancer and to reduce sampling errors. Our objective is to assess MR-TRUS targeted fusion biopsy versus standard biopsy for the detection of clinically significant tumors.Materials and Methods:Patients were referred for abnormal digital rectal examination (DRE) or risen prostate-specific antigen (PSA). If an MRI-visible lesion was detected, they were included in the study. In total, 102 men underwent MRI followed by MR-TRUS fusion biopsy between November 2014 and January 2016. Tumor grading was done with the clinical relevance in mind; a cutoff was used at Gleason 7 or higher. Standard biopsy results were collected from clinical practice during 2005 at the same institution to provide baseline values.Results:A comparable rate of prostate cancer is found whether sampling is done at random (42.4%) or with the use of fusion biopsy (44.1%). However, these percentages are histologically different: fewer low-grade tumors are detected with MR-TRUS fusion biopsy (–19.1%), while more high-grade tumors are diagnosed (+26%). If there is an ultrasound-visible lesion in the prostate, the gain of combined MRI and fusion biopsy is less impressive.Conclusion:Fusion biopsy can provide more accurate information for optimal patient management, as it detects a higher percentage of high-grade prostate cancers than random sampling. Furthermore, nonrelevant tumors are less commonly detected using fusion biopsy.
Highlights
Prostate cancer (CaP) is the most commonly diagnosed noncutaneous cancer and second-leading cause of death in men [1]
Low-grade cancers are more commonly stratified toward active surveillance [2, 3]; the correct assessment of tumor grade is very important for patient management
The increased cellularity reduces the water mobility, leading to “restricted diffusion,” which is characterized by a low apparent diffusion coefficient (ADC) [10, 11]
Summary
Prostate cancer (CaP) is the most commonly diagnosed noncutaneous cancer and second-leading cause of death in men [1]. The default assessment technique for the detection of CaP is based on lesion biopsy with histopathology. The most commonly used biopsy method is an at-random sampling of the entire organ. Magnetic resonance imaging makes it possible to noninvasively assess CaP (with high sensitivity) before any invasive biopsy procedure is performed [3,4,5,6,7,8]. Because of this superiority of MRI imaging in lesion detection (compared to ultrasound), new biopsy methods have emerged that use this MR-obtained information dur-
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