PURPOSE: We aimed to clarify the diagnostic ability of multiparametric magnetic resonance imaging (MP-MRI) to reveal anterior cancers missed by transrectal 12-core prostate biopsy (TR12PBx), based on the results of three-dimensional 26-core prostate biopsy (3D26PBx), a combination of TR12PBx and transperineal 14-core biopsy (TP14PBx) procedures.
MATERIALS AND METHODS: The study population consisted of 324 patients who prospectively underwent prebiopsy MP-MRI and then 3D26PBx at a single institution. We defined TR12-negative cancer as cancer detected by TP14PBx but not by TR12PBx. We focused on cancers located in the anterior region. Any suspicious findings for malignancy in the region anterior to the urethra on MP-MRI were defined as anterior lesion on MP-MRI. Significant cancer was defined as biopsy GS ≥ 4+3 and/or percent positive core > 20% and/or maximum cancer length ≥ 5mm. The associations between anterior lesion on MP-MRI and TR12-negative cancer were investigated.
RESULTS: The overall cancer detection rate by 3D26PBx was 39% (128/324), and of these 28% (36/128) were TR12-negative cancers. Anterior lesion on prebiopsy MP-MRI was identified in 20% (65/324) of the overall cohort. Of men with or without anterior lesion on MP-MRI, 40% (26/65) or 3.8% (10/259) had a TR12-negative cancer, respectively. Significant TR12-negative cancer was observed in 0.4% (1/259) of men without anterior lesion on MP-MRI. Prebiopsy MP-MRI presented anterior lesion in 92% (11/12) of significant TR12-negaitve cancers.
CONCLUSIONS: Prebiopsy MP-MRI has a potential to efficiently select men who could have advantages by anterior samplings in addition to TR12PBx.
Written by:
Komai Y, Numao N, Yoshida S, Matsuoka Y, Nakanishi Y, Ishii C, Koga F, Saito K, Masuda H, Fujii Y, Kawakami S, Kihara K. Are you the author?
Department of Urology, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan.
Reference: J Urol. 2013 Mar 28. pii: S0022-5347(13)03871-8.
doi: 10.1016/j.juro.2013.03.078
PubMed Abstract
PMID: 23542406
UroToday.com Prostate Cancer Section
