Ultrasound-MRI Fusion Prostate Biopsy: Experience from a Cancer Center in the Midwest

Abstract

Abstract Introduction/Objective Majority of literature with few exceptions suggests ultrasound-magnetic resonance imaging (MRI) fusion biopsy of prostate to be superior in diagnosing cancer compared to systematic transrectal ultrasonographic (TRUS) biopsy. However, it is highly dependent on the expertise of the person performing the biopsy and comes at a higher cost. The purpose of this study is a to evaluate the effectiveness of ultrasound-MRI fusion prostate biopsy at our institution. Methods/Case Report All prostate biopsies received at our institution from January to December 2022 were included. Data such as patient age, presence of region of interest (ROI) biopsy, presence of cancer in any core, presence of cancer in ROI core, total number of cores with cancer, highest Gleason score in ROI core, and highest Gleason score in other cores were collected. Results (if a Case Study enter NA) A total of 448 consecutive cases were identified. Of these 214 (47.8%) were transrectal ultrasonographic and 234 (52.2%) were ultrasound-MRI fusion biopsies. Mean age of patients with TRUS biopsy was 64.3±8.6 years and mean age of patients with MRI-guided biopsy was 65.4±6.9 years, a statistically comparable population (p-value 0.001). Among TRUS cases, 133 (62.1%) had tumor. Among ultrasound-MRI fusion cases, 169 (72.2%) had tumor. Among ultrasound-MRI fusion cases with tumor, 31 had cancer only in ROI core, 55 had cancer only in other cores and 83 had cancer in ROI core as well as at least one additional non-ROI core. Among 83 cases with tumor in ROI as well as non-ROI cores, 12 had higher Gleason score in ROI core, 18 had higher Gleason score in non-ROI core and in 53 cases the Gleason score in ROI core and highest Gleason score in any of the other positive cores were equal. Conclusion In our experience ultrasound-MRI fusion biopsy improves cancer detection; however, it does not improve the rate of detection of higher-grade cancer.