The detection of significant prostate cancer is correlated with the Prostate Imaging Reporting and Data System (PI-RADS) in MRI/transrectal ultrasound fusion biopsy

• Published in: World journal of urology 2016-04, Vol.34 (4), p.525-532
• Main Authors: Cash, Hannes, Maxeiner, Andreas, Stephan, Carsten, Fischer, Thomas, Durmus, Tahir, Holzmann, Josephine, Asbach, Patrick, Haas, Matthias, Hinz, Stefan, Neymeyer, Jörg, Miller, Kurt, Günzel, Karsten, Kempkensteffen, Carsten
• Format: Article
• Language: English
• Subjects: Aged; Biopsy, Large-Core Needle - methods; Follow-Up Studies; Humans; Image-Guided Biopsy - methods; Magnetic Resonance Imaging, Interventional - methods; Male; Medicine; Medicine & Public Health; Middle Aged; Neoplasm Grading; Nephrology; Oncology; Original Article; Prospective Studies; Prostate - pathology; Prostatic Neoplasms - diagnosis; Rectum; Reproducibility of Results; Ultrasonography, Interventional - methods; Urology
• ISSN: 0724-4983; 1433-8726
• DOI: 10.1007/s00345-015-1671-8

Purpose To evaluate the performance of real-time MRI/ultrasound (MRI/US) fusion-guided targeted biopsy (TB) in men with primary and repeat biopsies and correlate the prostate cancer detection rate (CDR) with the PI-RADS score. Methods Analysis included 408 consecutive men with primary and prior negative biopsies who underwent TB and 10-core random biopsy (RB) between January 2012 and January 2015. TB was performed with a real-time MRI/US fusion platform with sensor-based registration. Clinically significant PCa was defined as Gleason score (GS) ≥7 or GS 6 with maximal cancer core length ≥4 mm for TB and according to Epstein criteria for RB. Results The overall CDR was 56 % (227/408). The CDR for primary biopsy was 74 % (60/81) and 57 % (67/117), 49 % (62/126), 45 % (38/84) for patients with 1, 2 and ≥3 prior negative biopsies. CDRs correlated with PI-RADS 2/3/4/5 were 16 % (5/32), 26 % (29/113), 62 % (94/152) and 89 % (99/111), respectively. The rates of significant tumors in relation to PI-RADS 2/3/4/5 were 60 % (3/5), 66 % (19/29), 74 % (70/94), 95 % (94/99). In 139 (61 %) cases with radical prostatectomy (RP), the rates of ≥pT3 tumors in correlation with PI-RADS 4 and 5 were 20 % (11/56) and 49 % (32/65). PI-RADS constituted the strongest predictor of significant PCa detection ( p