Open AccessBi-parametric MRI/TRUS fusion targeted repeat biopsy after systematic 10-12 core TRUS-guided biopsy reveals more significant prostate cancer especially in anteriorly located tumors
Author(s) -
Michael Häggman,
Pär Dahlman,
Mats Ahlberg,
Per Liss,
Rafaele Cantera Ahlman,
Anca Dragomir,
Sam Ladjevardi
Publication year - 2022
Publication title -
acta radiologica open
Language(s) - English
Resource type - Journals
ISSN - 2058-4601
DOI - 10.1177/20584601221085520
Subject(s) - biopsy , medicine , prostate cancer , radiology , prostate biopsy , cancer , prostate , grading (engineering) , civil engineering , engineering
Background MRI and fusion guided biopsy have an increased role in the diagnosis of prostate cancer.Purpose To demonstrate the possible advantages with Bi-parametric MRI fusion-guided repeat biopsy over systematic 10–12-core biopsy for the diagnosis of prostate cancer.Material and Methods Four hundred and twenty-three consecutive men, with previous systematic 10–12-core TRUS-guided biopsy, and with suspicion of, or diagnosis of, low-risk prostate cancer underwent fusion-guided prostate biopsy between February 2015 and February 2017. The material was retrospectively assessed. In 220 cases no previous cancer was diagnosed, and in 203 cases confirmatory fusion guided biopsy was performed prior to active monitoring. MRI was classified according to PI-RADS. Systematic biopsy was compared to fusion guided biopsy for the detection of cancer, and PI-RADS was compared to the Gleason score.Results Fusion guided biopsy detected significantly more cancers than systematic ( p < .001). Gleason scores were higher in the fusion biopsy group ( p < .001). Anterior tumors were present in 54% of patients. Fusion biopsy from these lesions showed cancer in 53% with previously negative biopsy in systematic biopsies and 66% of them were upgraded from low risk to intermediate or high-risk cancers.Conclusion These results show superior detection rate and grading of bi-parametric MRI/TRUS fusion targeted repeat biopsy over systematic 10–12 core biopsies. Fusion guided biopsy detects more significant cancers despite using fewer cores. The risk group was changed for many patients initially selected for active surveillance due to upgrading of tumors. Bi-parametric MRI shows promising results in detecting anterior tumors in patients with suspected prostate cancer.