Visually Estimated MRI Targeted Prostate Biopsy Could Improve the Detection of Significant Prostate Cancer in Patients with a PSA Level <10 ng/mL.
10.3349/ymj.2016.57.3.565
- Author:
Dong Hoon LEE
1
;
Jong Kil NAM
;
Sung Woo PARK
;
Seung Soo LEE
;
Ji Yeon HAN
;
Sang Don LEE
;
Joon Woo LEE
;
Moon Kee CHUNG
Author Information
1. Department of Urology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea. mkchung@pusan.ac.kr
- Publication Type:Original Article
- Keywords:
Prostate cancer;
prostate biopsy;
magnetic resonance imaging
- MeSH:
Adenocarcinoma/blood/diagnosis/*pathology;
Aged;
Biopsy/*methods;
Endoscopic Ultrasound-Guided Fine Needle Aspiration/*methods;
Humans;
Magnetic Resonance Imaging/methods;
Magnetic Resonance Imaging, Interventional/methods;
Male;
Middle Aged;
Neoplasm Grading;
Prostate/diagnostic imaging/*pathology;
Prostate-Specific Antigen/*blood;
Prostatic Neoplasms/blood/diagnosis/*pathology;
Ultrasonography, Interventional/methods
- From:Yonsei Medical Journal
2016;57(3):565-571
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: To compare prostate cancer detection rates between 12 cores transrectal ultrasound-guided prostate biopsy (TRUS-Bx) and visually estimated multiparametric magnetic resonance imaging (mp-MRI)-targeted prostate biopsy (MRI-visual-Bx) for patients with prostate specific antigen (PSA) level less than 10 ng/mL. MATERIALS AND METHODS: In total, 76 patients with PSA levels below 10 ng/mL underwent 3.0 Tesla mp-MRI and TRUS-Bx prospectively in 2014. In patients with abnormal lesions on mp-MRI, we performed additional MRI-visual-Bx. We compared pathologic results, including the rate of clinically significant prostate cancer cores (cancer length greater than 5 mm and/or any Gleason grade greater than 3 in the biopsy core). RESULTS: The mean PSA was 6.43 ng/mL. In total, 48 of 76 (63.2%) patients had abnormal lesions on mp-MRI, and 116 targeted biopsy cores, an average of 2.42 per patient, were taken. The overall detection rates of prostate cancer using TRUS-Bx and MRI-visual-Bx were 26/76 (34.2%) and 23/48 (47.9%), respectively. In comparing the pathologic results of TRUS-Bx and MRI-visual-Bx cores, the positive rates were 8.4% (77 of 912 cores) and 46.6% (54 of 116 cores), respectively (p<0.001). Mean cancer core lengths and mean cancer core percentages were 3.2 mm and 24.5%, respectively, in TRUS-Bx and 6.3 mm and 45.4% in MRI-visual-Bx (p<0.001). In addition, Gleason score ≥7 was noted more frequently using MRI-visual-Bx (p=0.028). The detection rate of clinically significant prostate cancer was 27/77 (35.1%) and 40/54 (74.1%) for TRUS-Bx and MRI-visual-Bx, respectively (p<0.001). CONCLUSION: MRI-visual-Bx showed better performance in the detection of clinically significant prostate cancer, compared to TRUS-Bx among patients with a PSA level less than 10 ng/mL.
