English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Tools annual

Global: Zendy Free Plan

Global: Zendy Tools monthly

Global: Zendy Plus monthly

To evaluate and compare the benefits of multiparametric magnetic resonance imaging (mpMRI) in combination with fusion prostate biopsy (fPBx) and find out what happened with patients underwent single MRI without fPBx. Materials and methods: 125 patients underwent prostate mpMRI. Sixty-five of these patients additionally underwent ultrasound-guided fPBx. Prostate lesions were scored using the Prostate Imaging Reporting and Data System version 2, and the results were verified with prostate biopsies. Results: Sixty-five patients (52%) underwent fPBx after mpMRI, and 60 patients (48%) underwent mpMRI alone as ordered by their physician. Of the 65 men who underwent fPBx, PCa was verified in 33 men (50.77%) who exhibited suspicious lesions on mpMRI, whereas 20 men (30.77%) yielded negative results, although suspicious lesions were observed by mpMRI. Among the 65 men, 7 (10.76%) and 5 (7.7%) men had atypical small acinar proliferation and chronic prostatitis, respectively. The mean PCa detection rate for standard biopsy was 21.9% (SD, 26.4), whereas that of the mpMRI combined with fPBx was 49.5% (SD, 41.9) (p-value <0.0001). Of the 53 patients who underwent biopsy, 13 patients underwent the algorithm mpMRI/fPBx for first-line diagnosis, with nearly 70% patients (n=9) experiencing positive results. Conclusion: fPBx detected considerably more cases of PCa than standard biopsies, demonstrating the clear advantages of the former method. Because of the wellknown low specificity of mpMRI, this method alone is insufficient for the diagnosis of PCa if no further diagnostic interventions are planned. *Correspondence to: Lunacek A, Department of Urology, Hanusch Krankenhaus, Heinrich Collin Strasse, Vienna, Austria, Tel: 0043 91021 86011; Fax: 0043 91021 86019; E-mail: andreas.lunacek@acmp.at Received: October 21, 2019; Accepted: October 28, 2019; Published: October 30, 2019 Introduction Prostate cancer (PCa) is the most common cancer among the European population [1]. Prostate biopsies are recommended to verify PCa in patients with elevated prostate-specific antigen (PSA) levels and/or suspicious digital rectal exams (DREs) or Prostate Imaging Reporting and Data System (PIRADS) scores 3 upon mpMRI (European Association of Urology [EAU] Guidelines). The role of biopsies has changed since their introduction; in addition to cancer detection, biopsies are used for making clinical decisions regarding therapeutic planning and as follow-up tests for active surveillance. Data about histology, prostate specific antigen density, tumor location and extent are essential for accurate risk assessment regarding the biology and clinical aggressiveness of the encountered tumors [2-4]. The 10-12-core transrectal ultrasound-guided systematic mapping biopsy (TRUS-GB) is still the primary diagnostic modality for the detection of PCa [1,5]; however, this approach has a significant falsenegative rate of up to 47%, with up to 38% of patients undergoing a repeat prostate biopsy within 5 years [6-8]. The current index and extent of cancer is often underestimated, leading to a high rate of cancer upgrading and upstaging [9-11]. mpMRI as a single diagnostic tool for detecting PCa has limitations. The sensitivity (up to 93%) is high, but this can be compromised by motion artifacts, lack of standardized acquisition, analysis methods and lack of experience, leading to variabilities in the results. The specificity of 41% is low, and common signal alterations include postbiopsy changes, hyperplastic nodules and inflammation. Hence, mpMRI alone is not recommended for the detection of PCa and should not be used as a single examination for patients having prostate or PSA alterations although imaging and nuclear medical techniques become fundamental in the detection of prostate cancer [12-15]. Lunacek A (2019) Inadequate magnetic resonance imaging decision pattern in case of suspicious prostate alterations and the advantage of ultrasound target biopsies Volume 3: 2-8 Radiol Diagn Imaging, 2019 doi: 10.15761/RDI.1000163 We retrospectively evaluated the advantages of mpMRI combined with fPBx and distinguished inadequate decisions resulting from a single mpMRI. Patients and methods