Retrospective comparison of direct in-bore magnetic resonance imaging (MRI)-guided biopsy and fusion-guided biopsy in patients with MRI lesions which are likely or highly likely to be clinically significant prostate cancer

• Published in: World journal of urology Vol. 35; no. 12; pp. 1849 - 1855
• Main Authors: Venderink, Wulphert, van der Leest, Marloes, van Luijtelaar, Annemarijke, van de Ven, Wendy J. M., Fütterer, Jurgen J., Sedelaar, J. P. Michiel, Huisman, Henkjan J.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-12-2017; Springer Nature B.V
• Subjects: Aged; Biopsy; Clinical significance; Humans; Image-Guided Biopsy - methods; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; Magnetic Resonance Imaging, Interventional - methods; Male; Medicine; Medicine & Public Health; Neoplasm Grading; Nephrology; NMR; Nuclear magnetic resonance; Oncology; Original; Original Article; Prostate - diagnostic imaging; Prostate - pathology; Prostate cancer; Prostatic Neoplasms - pathology; Reproducibility of Results; Retrospective Studies; Ultrasonography, Interventional - methods; Ultrasound; Urology; Detection rate; Biopsy; Prostate; Direct in-bore; PI-RADS; MRI-TRUS fusion
• ISSN: 0724-4983; 1433-8726
• DOI: 10.1007/s00345-017-2085-6

Purpose
To compare clinically significant prostate cancer (csPCa) detection rates between magnetic resonance imaging (MRI)–transrectal ultrasound (TRUS) fusion-guided prostate biopsy (FGB) and direct in-bore MRI-guided biopsy (MRGB).
Methods
We performed a comparison of csPCa detection rates between FGB and MRGB. Included patients had (1) at least one prior negative TRUS biopsy; (2) a Prostate Imaging Reporting and Data System (PI-RADS) 4 or 5 lesion and (3) a lesion size of ≥8 mm measured in at least one direction. We considered a Gleason score ≥7 being csPCa. Descriptive statistics with 95% confidence intervals (CI) were used to determine any differences.
Results
We included 51 patients with FGB (59 PI-RADS 4 and 41% PI-RADS 5) and 227 patients with MRGB (34 PI-RADS 4 and 66% PI-RADS 5). Included patients had a median age of 69 years (IQR, 65–72) and a median PSA level of 11.0 ng/ml (IQR, 7.4–15.1) and a median age of 67 years (IQR, 61–70), the median PSA 12.8 ng/ml (IQR, 9.1–19.0) within the FGB and the MRGB group, respectively. Detection rates of csPCA did not differ significantly between FGB and MRGB, 49 vs. 61%, respectively.
Conclusion
We did not detect significant differences between FGB and MRGB in the detection of csPCa. The differences in detection ratios between both biopsy techniques are narrow with an increasing lesion size. This study warrants further studies to optimize selection of best biopsy modality.