PURPOSE: Given the limitations of prostate specific antigen and standard biopsies in detecting prostate cancer (CaP), we evaluate the Cancer Detection Rate (CDR) and external validity of Magnetic Resonance Imaging/Transrectal Ultrasound (MR/TRUS) fusion-guided prostate biopsy system being utilized at NIH.
MATERIALS AND METHODS: Phase-III Trial of MR/TRUS fusion-guided prostate biopsy system with participants enrolled between 2012 and 2013. 153 men consented to the study who underwent a 3T multi-parametric MRI with an endorectal coil for a clinical suspicion for CaP and had lesions classified into low or moderate/high risk for CaP. MR/TRUS fusion-guided biopsies and standard 12-core prostate biopsies were performed, and 105 men were eligible for analysis.
RESULTS: The mean age and PSA were 65.8 years and 9.5ng/mL respectively. The overall CDR was 62.9 % (66/105). The CDR in those with moderate/high risk on MP-MRI was 72.3% (47/65) versus 47.5% (19/40) in those classified as low risk for CaP (p< 0.05). The mean core length of tumor was 4.6 mm and 3.7 mm for fusion biopsy and standard 12-core biopsy respectively (p< 0.05). MR/TRUS fusion-guided biopsy detected CaP that was missed by standard 12-core biopsy in 14.3% (15/105), and 86.7% (13/15) were clinically significant. MR/TRUS fusion-guided biopsy upgraded 23.5% (4/17) of cancers deemed clinically insignificant on 12-core biopsy to clinically significant CaP necessitating treatment.
CONCLUSIONS: MR/TRUS fusion-biopsy can improve CaP detection. The results of this trial support the external validity of this platform and may be the next step in the evolution CaP management.
Written by:
Rastinehad AR, Turkbey B, Salami SS, Yaskiv O, George AK, Fakhoury M, Beecher K, Vira MA, Kavoussi LR, Siegel DN, Villani R, Ben-Levi E. Are you the author?
The Arthur Smith Institute for Urology, Hofstra North Shore-LIJ School of Medicine, New Hyde Park, NY 11042; Department of Radiology and Interventional Radiology, Hofstra North Shore-LIJ School of Medicine, New Hyde Park, NY 11042; Molecular Imaging Program, National Institutes of Health, Bethesda, MD 20892; The Arthur Smith Institute for Urology, Hofstra North Shore-LIJ School of Medicine, New Hyde Park, NY 11042; Department of Pathology, Hofstra North Shore-LIJ School of Medicine, New Hyde Park, NY 11042; Department of Radiology and Interventional Radiology, Hofstra North Shore-LIJ School of Medicine, New Hyde Park, NY 11042.
Reference: J Urol. 2013 Dec 11. pii: S0022-5347(13)06089-8.
doi: :10.1016/j.juro.2013.12.007
PubMed Abstract
PMID: 24333515
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