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Updated: Nov 11, 2025
Use of Magnetic Resonance Imaging and Biopsy Data to Guide Sampling Procedures for Prostate Cancer Biobanking
Published on: October 10, 2019
In-Bore MRI-guided Prostate Biopsies: Retrospective Observational Study of Complementary Nontargeted Sampling of
Kareem K Elfatairy1, Christopher P Filson1, Martin G Sanda1
1Department of Radiology and Imaging Sciences (K.K.E., S.G.N.), Interventional MRI Program (K.K.E., S.G.N.), Department of Urology (C.P.F., M.G.S., A.O.O.), and Department of Pathology (A.O.O.), Emory University School of Medicine, 1364 Clifton Rd NE, Atlanta, GA 30322; Atlanta Veterans Affairs Medical Center, Decatur, Ga (C.P.F., M.G.S.); Emory Winship Cancer Institute, Atlanta, Ga (C.P.F., M.G.S., A.O.O., S.G.N.); Department of Pathology, Veterans Affairs Medical Center, Atlanta, Ga (A.O.O.); and Department of Radiology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt (K.K.E.).
Additional biopsies from MR-invisible areas in prostate MRI-guided procedures can detect clinically significant cancers (CSCs). These biopsies are crucial, especially for biopsy-naive patients, improving diagnostic accuracy and patient management.
Area of Science:
- Urology
- Radiology
- Oncology
Background:
- Prostate cancer diagnosis relies on imaging and biopsy.
- In-bore MRI-guided biopsy enhances detection of suspicious lesions.
- The diagnostic yield of non-targeted areas requires further investigation.
Purpose of the Study:
- To evaluate the pathological outcomes of random biopsies from MR-invisible areas during MRI-guided prostate biopsy.
- To determine the negative predictive value (NPV) of these areas, stratified by prior biopsy status.
Main Methods:
- Retrospective analysis of 59 patients undergoing in-bore MRI-guided biopsy with random biopsies of MR-invisible areas (PI-RADS v2 category 1 or 2).
- Clinically significant cancers (CSCs) defined as Gleason score ≥ 7.
- NPVs calculated and stratified by patient biopsy history (naive, prior negative, prior positive).
Main Results:
- Prostate cancer detected in 71.2% of patients.
- 17.9% of biopsies from MR-invisible areas yielded cancer, including 9.8% CSCs.
- Overall NPV for MR-invisible areas was 78% for any cancer and 88.1% for CSCs, varying by biopsy status.
Conclusions:
- MR-invisible areas can harbor clinically significant prostate cancers.
- Additional random biopsies from these areas are recommended for improved detection and management.
- Biopsy status significantly impacts the NPV of MR-invisible areas.
