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A Cognitive Fusion-guided Prostate Biopsy Using Multiparametric Magnetic Resonance Imaging and Transrectal Ultrasound
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Targeted MRI-guided prostate biopsy: are two biopsy cores per MRI-lesion required?
L Schimmöller1, M Quentin2, D Blondin1
1Medical Faculty, Department of Diagnostic and Interventional Radiology, University Dusseldorf, Moorenstr. 5, D-40225, Dusseldorf, Germany.
European Radiology
|February 28, 2016
Summary
Reducing prostate biopsy cores is feasible. A second core per MRI-lesion offers minimal benefit for prostate cancer detection and Gleason upgrading, suggesting fewer biopsies are reasonable for MR-guided in-bore prostate biopsy.
Area of Science:
- Urology
- Radiology
- Oncology
Background:
- Prostate cancer (PCa) diagnosis relies on accurate tissue sampling.
- MR-guided in-bore prostate biopsy is an evolving technique for targeted sampling.
Purpose of the Study:
- To assess the feasibility of reducing core biopsies per MRI-lesion in targeted prostate biopsies.
- To determine the added value of a second biopsy core compared to the first.
Main Methods:
- Retrospective analysis of 1545 biopsy cores from 774 intraprostatic lesions in 290 patients.
- Comparison of prostate cancer detection, Gleason score, and tumor infiltration between the first (FBC) and second (SBC) biopsy cores.
- Biopsies were acquired under MR-guidance.
Main Results:
- PCa detection rates were similar for FBC (46%) and SBC (48%).
- Clinically significant PCa detection rates were 18% for both FBC and SBC.
- The SBC detected cancer in 7.5% of lesions with a negative FBC, and Gleason upgrading occurred in 3.1% of cases.
Conclusions:
- The incremental benefit of a second core biopsy per lesion is minor for PCa detection and Gleason upgrading.
- A reduction in the number of biopsy cores per MRI-lesion is a reasonable consideration.
- Higher PI-RADS scores correlate with PCa detection.
