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A Cognitive Fusion-guided Prostate Biopsy Using Multiparametric Magnetic Resonance Imaging and Transrectal Ultrasound
Published on: March 21, 2025
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Risk of Prostate Cancer after a Negative Magnetic Resonance Imaging Guided Biopsy
Adam Kinnaird1, Vidit Sharma1, Ryan Chuang1
1Department of Urology, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California.
The Journal of Urology
|July 3, 2020
Summary
Men with negative MRI-guided prostate biopsy results are unlikely to have significant cancer. Repeat MRI-guided biopsy is only warranted if follow-up imaging reveals suspicious lesions, indicating potential cancer.
Area of Science:
- Urology
- Radiology
- Oncology
Background:
- Magnetic resonance imaging (MRI) guided biopsy offers reassurance after negative results, but follow-up confirmation is limited.
- Prostate specific antigen (PSA) testing is common after negative MRI-guided biopsies, with few reports on tissue confirmation.
Purpose of the Study:
- To investigate the incidence of clinically significant prostate cancer in men with an initial negative MRI-guided biopsy who underwent repeat biopsy due to persistent suspicion.
Main Methods:
- Retrospective analysis of men with negative initial MRI-guided biopsies who underwent repeat MRI-ultrasound fusion biopsies.
- Targeted and systematic cores were obtained, focusing on initial and follow-up MRI regions of interest.
- Primary endpoint was detection of clinically significant prostate cancer (Gleason Grade Group 2 or greater).
Main Results:
- Of 733 men with negative initial MRI-guided biopsies, 73 underwent repeat biopsy.
- Twenty-three percent (17/73) were diagnosed with clinically significant prostate cancer at repeat biopsy (median 2.4 years later).
- Cancer detection was significantly higher when follow-up MRI revealed lesions (32%) compared to negative follow-up MRI (0%).
Conclusions:
- Negative follow-up MRI after an initial negative MRI-guided prostate biopsy suggests a low likelihood of clinically significant cancer.
- Repeat MRI-guided biopsy is recommended when follow-up MRI demonstrates suspicious lesions (PI-RADS 3 or greater).
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