OBJECTIVES: To assess the accuracy of magnetic resonance imaging (MRI)/ trans-rectal ultrasound (TRUS)-fusion of first-round biopsies in the diagnosis of localised prostate cancer (PCa) in men with a PSA ≤ 10 ng/ml.
PATIENTS AND METHODS: A prospective study was conducted on men with the following criteria: first-round biopsy, multiparametric MRI with a lesion with a Likert score ≥2 and a PSA < 10 ng/ml. All men underwent a 12 extended-cores protocol (STD) plus a protocol of 2 or 3 targeted cores on the multiparametric MRI (mpMRI) index lesion. The UroStation™ (Koelis, France) and a V10 ultrasound system with an end-fire 3D TRUS transducer were used for the fusion images procedure. A significant PCa was defined as: at least one core with a Gleason score of 3 + 4 or 6 with a maximal cancer core length (MCL) ≥4 mm.
RESULTS: Overall, 152 men were included with a median PSA level of 6 ng/ml. The proportion of cores positive was significantly higher with the TAR protocol than with the STD protocol (p< 0.001). The proportion of men with clinically significant cancer was higher with the TAR protocol than with the STD protocol (p=0.03). The proportion of patients having at least one positive biopsy (TAR protocol) was significantly different according to the Likert score category (p< 0.0001). The monocentric nature of the study was a limitation.
CONCLUSIONS: For the first round of biopsies, MRI/TRUS-fusion targeted biopsies detected more men with clinically significant PCa than standard 12 biopsy cores alone.
Written by:
Mozer P, Rouprêt M, Le Cossec C, Granger B, Comperat E, de Gorski A, Cussenot O, Renard-Penna R. Are you the author?
AP-HP, Hopital Pitié-Salpétrière, Academic Department of Urology, Paris, F-75013, France; UPMC Univ Paris 06, ISIR, F-75005, Paris, France.
Reference: BJU Int. 2014 Feb 19. Epub ahead of print.
doi: 10.1111/bju.12690
PubMed Abstract
PMID: 24552477
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