PURPOSE: We aimed to investigate prostate cancer detection rate of magnetic resonance imaging (MRI)-guided biopsy and to elucidate possible relations to the number of prior negative transrectal ultrasonography (TRUS)-guided biopsies.
MATERIALS AND METHODS: Eighty-seven consecutive patients (mean age, 65.0 years; mean prostate-specific antigen, 13.3 ng/mL) with at least one prior negative TRUS-guided biopsy and persistent suspicion of prostate cancer were included in this study. All patients underwent MRI-guided biopsy after a diagnostic multiparametric MRI examination at 1.5 Tesla. Specimens were immediately fixated and subsequently evaluated by an experienced uropathologist. Prostate cancer detection rates were calculated. Prostate cancer-positive and -negative cores were compared. Correlation between number of prior biopsies and presence of prostate cancer was evaluated.
RESULTS: Cancer detection rates for patients with one (n=24), two (n=25), three (n=18), and four or more (n=20) negative TRUS-guided biopsies were 29.2%, 40.0%, 66.7%, and 35.0%, respectively (P = 0.087). The median number of removed cores per patient was 3 (range, 1-8) without a significant difference between patients with and without cancer (P = 0.48). Thirty of 36 cancer patients were at intermediate or high risk according to the D´Amico clinical risk score. Eleven of 15 high risk cancers were localized in the transition zone (P = 0.002).
CONCLUSIONS: This study demonstrates high cancer detection rates of MRI-guided biopsy independent of the number of previous TRUS-guided biopsies and the number of taken prostate cores. MRI-guided biopsy therefore represents a less invasive and effective diagnostic tool for patients with prostate cancer suspicion and previous negative TRUS-guided biopsies.
Written by:
Durmus T, Reichelt U, Huppertz A, Hamm B, Beyersdorff D, Franiel T. Are you the author?
Institute of Radiology, Charite Universitaetsmedizin, Berlin, Germany.
Reference: Diagn Interv Radiol. 2013 Sep-Oct;19(5):411-7.
doi: 10.5152/dir.2013.13055
PubMed Abstract
PMID: 23886937
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