A prospective comparison of MRI-US fused targeted biopsy versus systematic ultrasound-guided biopsy for detecting clinically significant prostate cancer in patients on active surveillance

• Published in: Journal of magnetic resonance imaging 2015-01, Vol.41 (1), p.220-225
• Main Authors: Da Rosa, Michael R., Milot, Laurent, Sugar, Linda, Vesprini, Danny, Chung, Hans, Loblaw, Andrew, Pond, Gregory R., Klotz, Laurence, Haider, Masoom A.
• Format: Article
• Language: English
• Subjects: active surveillance; Adult; Aged; Humans; Image-Guided Biopsy - methods; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; Male; Medical research; Middle Aged; MRI-ultrasound fusion biopsy; Multimodal Imaging - methods; multiparametric MRI; Multivariate analysis; Predictive Value of Tests; Prospective Studies; prostate; Prostate - diagnostic imaging; Prostate - pathology; Prostate cancer; Prostatic Neoplasms - diagnosis; Reproducibility of Results; Surveillance; Ultrasonic imaging; Ultrasonography, Interventional - methods
• ISSN: 1053-1807; 1522-2586
• DOI: 10.1002/jmri.24710

Background In active surveillance (AS) patients: (i) To compare the ability of a multiparametric MRI (mpMRI)‐ultrasound biopsy system to detect clinically significant (CS) prostate cancer with systematic 12‐core biopsy (R‐TRUSBx), and (ii) To assess the predictive value of mpMRI with biopsy as the reference standard. Methods Seventy‐two men on AS prospectively underwent 3T mpMRI . MRI‐ultrasound fusion biopsy (UroNavBx) and R‐TRUSBx was performed. CS cancer was defined using two thresholds: 1) GS ≥ 7 (CS7) and 2) GS = 6 with >50% involvement (GS6). CS cancer detection rates and predictive values were determined. Results CS7 cancers were found in 19/72 (26%), 7 (37%) identified by UroNavBx alone, 2 (11%) by R‐TRUSBx alone (P = 0.182). UroNav targeted biopsy was 6.3× more likely to yield a core positive for CS7 cancer compared with R‐TRUSBx (25% of 141 versus 4% of 874, P