You have accessJournal of UrologyProstate Cancer: Detection & Screening II1 Apr 2014MP53-12 ASSOCIATION OF QUANTITATIVE MAGNETIC RESONANCE IMAGING PARAMETERS WITH HISTOLOGICAL FINDINGS FROM MRI-ULTRASOUND FUSION PROSTATE BIOPSY Seyed Saeid Dianat, H. Ballentine Carter, Edward M. Schaeffer, Ulrike M. Hamper, Jonathan I. Epstein, and Katarzyna J. Macura Seyed Saeid DianatSeyed Saeid Dianat More articles by this author , H. Ballentine CarterH. Ballentine Carter More articles by this author , Edward M. SchaefferEdward M. Schaeffer More articles by this author , Ulrike M. HamperUlrike M. Hamper More articles by this author , Jonathan I. EpsteinJonathan I. Epstein More articles by this author , and Katarzyna J. MacuraKatarzyna J. Macura More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1643AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail Introduction and Objectives Magnetic resonance – transrectal ultrasound (MR-TRUS) fusion biopsy of the prostate is a promising office-based technique to target lesions identified on multiparametric MRI (mp-MRI). The aim of this study was to evaluate the diagnostic yield of MR-TRUS fusion biopsy in men with high PSA level and negative or non-reassuring prior biopsies, and to study associations of quantitative MR parameters with biopsy findings. Methods 26 patients who had 3.0 T mp-MRI and subsequent MR-TRUS fusion biopsy with GE Logiq 9 were included (16 men with high PSA and negative biopsies, 5 men in active surveillance (AS), 4 men for pre-treatment evaluation, and 1 man with post-brachytherapy biochemical recurrence). The mp-MRI consisted of T2-weighted (T2W), diffusion weighted (DWI), and dynamic contrast enhanced (DCE) images. A total of 50 MR-identified targets (median volume: 0.83 cm3) were adequately sampled by 120 cores using an 18 gauge biopsy device. The quantitative MR profiles were compared among benign, cancer-positive, and higher-grade cancer-positive (Gleason > 6) targets using Mann–Whitney U-test. Results Of 50 targets, biopsy showed benign tissue in 31 (62%), cancer in 16 (32%), and atypia or high-grade prostatic intraepithelial neoplasia in 3 (6%) targets. The cancer-positive targets (median volume: 1.77 cm3) were located in the transition zone in 56.3% of targets. 12 of 25 (48%) cancer-positive cores were higher-grade. Higher-grade and cancer-positive targets compared with benign targets exhibited lower apparent diffusion coefficient (ADC) (983.3 < 1062 < 1261), higher permeability coefficient (Ktrans) (7.45 > 6.4 > 5.72) and lower extracellular volume fraction (ECF) (0.447 < 0.461 < 0.520), respectively. The difference in parameters was more pronounced between higher-grade cancers and benign targets (Table). ADC was the most predictive parameter to detect cancer-positive targets. Conclusions Quantitative MR parameters predict malignant histology on MR-TRUS fusion biopsy of the prostate, which is a valuable technique to ensure adequate sampling of MR-visible suspicious lesions under TRUS guidance and with impact on patient management. Summary of quantitative MR profile of 50 targets; comparison between benign targets, cancer-positive targets and higher-grade (Gleason > 6) cancer-positive targets Benign target†(n = 34) Cancer-positive target (n = 16) Higher-grade (Gleason > 6) cancer-positive target (n = 6) P-value (benign vs cancer-positive target) P-value (benign vs higher-grade cancer-positive target) MR suspicion score 2.32 ± 0.59 3.27 ± 1.1 4.0 ± 1.0 0.002 0.001 Mean T2SI 267.9 ± 79.3 225.8 ± 88.5 182.4 ± 72 0.09 0.01 Mean ADC 1261 ± 178.2 1062.4 ± 173.3 983.3 ± 175.9 0.002 0.003 Mean Ktrans 5.72 ± 7.69 6.40 ± 6.25 7.45 ± 6.22 0.51 0.29 Mean EVF 0.520 ± 0.147 0.461 ± 0.116 0.447 ± 0.105 0.24 0.31 Mean Kep 10.61 ± 13.25 15.30 ± 15.71 18.57 ± 16.45 0.29 0.21 Values are shown as mean ± SD. SI: signal intensity, ADC: Apparent diffusion coefficient, Ktrans: permeability rate, EVF: extracellular volume fraction, and Kep: contrast efflux rate constant. † Benign targets consisted of benign tissue, HGPIN or atypia in the targeted biopsy. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e593 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Seyed Saeid Dianat More articles by this author H. Ballentine Carter More articles by this author Edward M. Schaeffer More articles by this author Ulrike M. Hamper More articles by this author Jonathan I. Epstein More articles by this author Katarzyna J. Macura More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...