The complication rates of systematic TRUS and MRI-TRUS fusion prostate biopsies had no significant differences between the two procedures. The complication rates in both techniques were very low (1.7% in MRI-TRUS versus 1.9% in TRUS) and were mostly grades 2 and 3, with no cases of complications grades 4 and 5. When comparing early and late complication rates, also no significant difference between systematic TRUS and MRI-TRUS fusion prostate biopsies were observed, suggesting that both procedures are safe and MRI-TRUS fusion prostate biopsies did not increase the rate of adverse events.
Figure - Extrapolated scatter plot to mpMRI-TRUS targets in coronal view of the prostate (black dots represent each target of mpMRI)
The present study was limited as a retrospective non-randomized study with patients that may have had clinical characteristics which led urologists to request MRI prior to the biopsies that were not accounted for in the present study, and a lack of uniformity of criteria for prostate biopsy indications such as high PSA levels, abnormalities on digital rectal examination, or MRI imaging findings prior to the biopsy. Other factors that could affect complication rates (e.g., diabetes) also were not compared between both groups, but this study inserts the knowledge that increasing the use of fusion biopsies will not lead to higher rates of complications. In addition, despite a higher incidence of cores close to the prostatic urethra, as we can see in the following figure, the MRI-TRUS fusion prostate biopsy is not related to a significant increase of adverse events.
Written by: Priscila Mina Falsarella, MD, Department of Interventional Radiology, Hospital Israelita Albert Einstein, São Paulo, Brazil
Read the Abstract