Effectiveness of Bi-Parametric MR/US Fusion Biopsy for Detecting Clinically Significant Prostate Cancer in Prostate Biopsy Naïve Men
10.3349/ymj.2019.60.4.346
- Author:
Young Joo KIM
1
;
Jung Sik HUH
;
Kyung Kgi PARK
Author Information
1. Department of Urology, School of Medicine, Jeju National University, Jeju, Korea. urology.park@gmail.com
- Publication Type:Original Article
- Keywords:
Prostate cancer;
MRI;
ultrasound;
image-guided biopsy;
diffusion
- MeSH:
Biopsy;
Diffusion;
Humans;
Image-Guided Biopsy;
Information Systems;
Magnetic Resonance Imaging;
Male;
Prostate;
Prostate-Specific Antigen;
Prostatic Neoplasms;
Ultrasonography
- From:Yonsei Medical Journal
2019;60(4):346-351
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: To explore the effect of bi-parametric MRI-ultrasound (MR/US) fusion prostate biopsy on the detection of overall cancer and significant prostate cancer (sPCa). MATERIALS AND METHODS: We examined 140 patients with suspected prostate cancer lesions on MRI from August 2016 to March 2018. All patients had undergone 3T pre-biopsy bi-parametric (T2 weighted and diffusion-weighted) prostate MRI (bpMRI), and their MRI images were evaluated with Prostate Imaging Reporting and Data System (PI-RADS) version 2.0. MR/US fusion targeted prostate biopsy was performed for lesions with a PI-RADS score ≥3 before systemic biopsy. The results of targeted and systemic biopsy were evaluated in regards to detection rate according to PI-RADS score. RESULTS: Of the patients (mean age=67.2 years, mean prostate-specific antigen level=8.1 ng/mL), 66 (47.1%) and 37 (26.4%) patients were diagnosed with cancer and significant prostate cancer, respectively. The rate of positive targeted biopsy increased with higher PI-RADS score (3: 40.4%, 4: 56.7%, 5: 90.0%). The proportion of significant prostate cancer among positive target lesions was 65.3% (32/49). CONCLUSION: bpMRI is a feasible tool with which to identify sPCa. MR/US fusion biopsy, rather than systemic biopsy, can help identify sPCa. We recommend using supplemental tools to increase prostate cancer detection in patients with PI-RADS 3 lesions.
