Open AccessMRI-TRUS fusion guided prostate biopsy – initial experience and assessment of the role of contralateral lobe systematic biopsy
Author(s) -
Iulia Andraș,
Dana Crişan,
Emanuel Darius Căta,
Attila Tamas-Szora,
Cosmin Caraiani,
Radu-Tudor Coman,
Cătălina Bungărdean,
Claudiu Mirescu,
Ioan Coman,
Nicolae Crișan
Publication year - 2019
Publication title -
medical ultrasonography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.473
H-Index - 28
eISSN - 2066-8643
pISSN - 1844-4172
DOI - 10.11152/mu-1705
Subject(s) - medicine , biopsy , radiology , prostate biopsy , prostate cancer , prostate , cancer
Aims: To present our initial experience and results of MRI-TRUS fusion guided prostate biopsy and assess the role of contralateral lobe systematic biopsy.Material and method: A number of 119 patients with clinical or biochemical suspicion for prostate cancer (PCa) were included. All patients harbored at least one PIRADS score ≥ 3 lesion and underwent MRI-TRUS fusion guided biopsy, as well as a concurrent systematic biopsy. The biopsy was performed by the same operator, using a rigidregistration software system.Results: The mean age of the patients was 62.2 years. The mean pre-biopsy PSA was 9.15 ng/dl. The diagnosis rate of MRI-TRUS fusion guided biopsy was 47% for overall PCa and 29.4% for clinically significant (cs) PCa. A higher PIRADS score was significantly associated with the presence of overall and csPCa. MRI-TRUS fusion guided biopsy had a higher percentage of positive biopsy cores (51% vs 29%), higher likelihood of csPCa (OR 5.36, p=0.008) and upgrading (14.8%) in comparison with systematic biopsy but missed 6.7% csPCa. The contralateral lobe systematic biopsy could have been avoided without losing the PCa diagnosis all patients with PIRADS score 5, both in initial and repeat biopsy setting. Anterior and transitional lesions were more likely to be diagnosed only by targeted cores.Conclusion: MRI-TRUS guided prostate biopsy improves the detection of PCa, but systematic biopsy is still essential. In selected cases (PIRADS 5), contralateral lobe systematic biopsy can safely be avoided. Pre-biopsy mpMRI might reduce the number of biopsy sessions in patients with anterior and transitional lesions.