You have accessJournal of UrologyProstate Cancer: Detection & Screening (II)1 Apr 20131472 MAGNETIC RESONANCE IMAGING GUIDED PROSTATE BIOPSY VERSUS SYSTEMATIC 14-CORE PROSTATE BIOPSY INCLUDING ANTERIOR SAMPLINGS IN DETECTING SIGNIFICANT CANCER AND ASSESSING CANCER AGGRESSIVENESS Noboru Numao, Masaya Ito, Hiroshi Fukushima, Hideki Takeshita, Soichiro Yoshida, Yoh Matsuoka, Fumitala Koga, Kazutaka Saito, Hitoshi Masuda, Yasuhisa Fujii, Satoru Kawakami, and Kazunori Kihara Noboru NumaoNoboru Numao Tokyo, Japan More articles by this author , Masaya ItoMasaya Ito Tokyo, Japan More articles by this author , Hiroshi FukushimaHiroshi Fukushima Tokyo, Japan More articles by this author , Hideki TakeshitaHideki Takeshita Tokyo, Japan More articles by this author , Soichiro YoshidaSoichiro Yoshida Tokyo, Japan More articles by this author , Yoh MatsuokaYoh Matsuoka Tokyo, Japan More articles by this author , Fumitala KogaFumitala Koga Tokyo, Japan More articles by this author , Kazutaka SaitoKazutaka Saito Tokyo, Japan More articles by this author , Hitoshi MasudaHitoshi Masuda Tokyo, Japan More articles by this author , Yasuhisa FujiiYasuhisa Fujii Tokyo, Japan More articles by this author , Satoru KawakamiSatoru Kawakami Tokyo, Japan More articles by this author , and Kazunori KiharaKazunori Kihara Tokyo, Japan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2937AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Many studies have compared diagnostic ability of magnetic resonance imaging (MRI) guided biopsy (MRBX) and transrectal extended biopsy, however comparison of MRBX and extended biopsy including anterior samplings has little been investigated. Aim of our study is to directly compare diagnostic ability of MRBX and transrectal ultrasound (TRUS)-guided systematic 14-core biopsy including transperineal anterior samplings (SBX). METHODS We prospectively evaluated 120 consecutive men with PSA level between 2.5-20 ng/ml and/or digital rectal examination (DRE) for suspected clinically localized disease and with positive results on prebiopsy MRI. A 1.5T MRI included T2-weighted, diffusion-weighted and/or dynamic contrast-enhanced imaging. All men underwent MRBX and SBX. During the biopsy, MRI results were displayed so that the suspected lesion on MRI was visually matched with the corresponding location on TRUS. MRBX protocol was 4-core samplings for one suspected lesion on MRI. The SBX protocol was a transperineal 14-core biopsy or a combined 14-core biopsy of transperineal 8-core and transrectal 6-core biopsies, and each biopsy included 6 or 4 anterior samplings, respectively. Biopsy specimens were evaluated according to the 2005 modified Gleason grading system. We defined indolent cancer (IC) as PSA < 10 ng/ml, DRE-based clinical stage T1a-T2a, biopsy Gleason score (GS) </= 3+4, and maximum cancer length (MCL) < 5 mm. Cancer other than IC was defined as SC. Detection capability of SC and ability to identify the highest GS and MCL as indicators of cancer aggressiveness were compared between MRBX and SBX. RESULTS Median PSA was 8.3 ng/ml. Number of suspected lesions on MRI was one/two/three in 107/11/2 cases, respectively. Biopsy results in combination of MRBX and SBX were no cancer/IC/SC in 34/11/75 cases, respectively. MRBX/SBX detected 3/10 IC and 67/70 SC, respectively. MRBX had equivalent ability to SBX in detecting SC (p = 0.695), while MRBX detected significantly fewer IC compared to SBX (p = 0.046). In 63 SC that both MRBX and SBX detected, MRBX/SBX identified the highest GS in 48/44 cases and MCL in 45/45 cases, respectively. No significant difference between MRBX and SBX were found in identifying the highest GS (p = 0.422) and MCL (p = 1.000). CONCLUSIONS MRI guided biopsy with 4 cores for one suspected lesion has equivalent ability to detect significant cancer and assess cancer aggressiveness compared to systematic 14-core biopsy including anterior samplings. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e603-e604 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Noboru Numao Tokyo, Japan More articles by this author Masaya Ito Tokyo, Japan More articles by this author Hiroshi Fukushima Tokyo, Japan More articles by this author Hideki Takeshita Tokyo, Japan More articles by this author Soichiro Yoshida Tokyo, Japan More articles by this author Yoh Matsuoka Tokyo, Japan More articles by this author Fumitala Koga Tokyo, Japan More articles by this author Kazutaka Saito Tokyo, Japan More articles by this author Hitoshi Masuda Tokyo, Japan More articles by this author Yasuhisa Fujii Tokyo, Japan More articles by this author Satoru Kawakami Tokyo, Japan More articles by this author Kazunori Kihara Tokyo, Japan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...