scholarly journals Visibility of MRI prostate lesions on B-mode transrectal ultrasound

2018 ◽  
Vol 20 (4) ◽  
pp. 441
Author(s):  
Fabian Steinkohl ◽  
Anna Katharina Luger ◽  
Renate Pichler ◽  
Jasmin Bektic ◽  
Peter Rehder ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Significant Influence ◽  
Detection Rate ◽  
Prostate Volume ◽  
Transrectal Ultrasound ◽  
Multiparametric Mri ◽  
Targeted Biopsy ◽  
Prostate Biopsies ◽  
Clinically Significant

Aim: Prostate biopsies are usually done with transrectal ultrasound (TRUS) in B-mode (B TRUS) but multiparametric MRI (mpMRI) is the gold imaging standard for the visualization of clinically significant prostate cancer (PCa), since a lowPCa detection rate is reported for B TRUS. The aim of this study was to assess the visibility of MRI lesions on B TRUS and to determine which factors may influence the visibility on B TRUS.Material and methods: 142 men with 148 lesions reported on mpMRI underwent a B TRUS/mpMRI fusion targeted biopsy of the prostate and were included in this retrospective study. During the biopsy, images were obtained and stored in the institution’s PACS. These images were reviewed by two radiologists to determine, whether an mpMRI lesion was or was not visible on B TRUS.Results: Overall 92 from 148 mpMRI lesions (62.2%) were visible on B TRUS. The location of the lesion in the prostate, the PIRADS classification of the lesions and the size of the lesion had no significant influence on the visibility on B TRUS. Only the prostate volume had a significant influence on visibility: in smaller prostates significantly more lesions were visible on B TRUS than in large glands (p+0.041; 45.1 ml vs 54 ml).Conclusion: The use of newer high-end ultrasound units as well as experience gained from fusion biopsies enables us to see 62.2 % of all suspicious mpMRI lesions on B TRUS. B TRUS images merit a thorough examination during a conventional biopsy setting.

scholarly journals Study protocol for a single-centre non-inferior randomised controlled trial on a novel three-dimensional matrix positioning-based cognitive fusion-targeted biopsy and software-based fusion-targeted biopsy for the detection rate of clinically significant prostate cancer in men without a prior biopsy

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e041427
Author(s):  
Biming He ◽  
Rongbing Li ◽  
Dongyang Li ◽  
Liqun Huang ◽  
Xiaofei Wen ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Detection Rate ◽  
Three Dimensional ◽  
Multiparametric Mri ◽  
Fusion Method ◽  
Targeted Biopsy ◽  
Cognitive Fusion ◽  
Single Centre ◽  
Clinically Significant ◽  
Randomised Controlled

IntroductionThe classical pathway for diagnosing prostate cancer is systematic 12-core biopsy under the guidance of transrectal ultrasound, which tends to underdiagnose the clinically significant tumour and overdiagnose the insignificant disease. Another pathway named targeted biopsy is using multiparametric MRI to localise the tumour precisely and then obtain the samples from the suspicious lesions. Targeted biopsy, which is mainly divided into cognitive fusion method and software-based fusion method, is getting prevalent for its good performance in detecting significant cancer. However, the preferred targeted biopsy technique in detecting clinically significant prostate cancer between cognitive fusion and software-based fusion is still beyond consensus.Methods and analysisThis trial is a prospective, single-centre, randomised controlled and non-inferiority study in which all men suspicious to have clinically significant prostate cancer are included. This study aims to determine whether a novel three-dimensional matrix positioning cognitive fusion-targeted biopsy is non-inferior to software-based fusion-targeted biopsy in the detection rate of clinically significant cancer in men without a prior biopsy. The main inclusion criteria are men with elevated serum prostate-specific antigen above 4–20 ng/mL or with an abnormal digital rectal examination and have never had a biopsy before. A sample size of 602 participants allowing for a 10% loss will be recruited. All patients will undergo a multiparametric MRI examination, and those who fail to be found with a suspicious lesion, with the anticipation of half of the total number, will be dropped. The remaining participants will be randomly allocated to cognitive fusion-targeted biopsy (n=137) and software-based fusion-targeted biopsy (n=137). The primary outcome is the detection rate of clinically significant prostate cancer for cognitive fusion-targeted biopsy and software-based fusion-targeted biopsy in men without a prior biopsy. The clinically significant prostate cancer will be defined as the International Society of Urological Pathology grade group 2 or higher.Ethics and disseminationEthical approval was obtained from the ethics committee of Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China. The results of the study will be disseminated and published in international peer-reviewed journals.Trial registration numberClinicalTrials.gov Registry (NCT04271527).

scholarly journals MRI-Targeted Biopsies versus Systematic Transrectal Ultrasound Guided Biopsies for the Diagnosis of Localized Prostate Cancer in Biopsy Naïve Men

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Alexandre Peltier ◽  
Fouad Aoun ◽  
Marc Lemort ◽  
Félix Kwizera ◽  
Marianne Paesmans ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Gleason Score ◽  
Cancer Detection ◽  
Detection Rate ◽  
Transrectal Ultrasound ◽  
Cancer Detection Rate ◽  
Targeted Biopsy ◽  
Clinically Significant ◽  
A Prospective Study ◽  
Significant Disease

Introduction. To compare, in the same cohort of men, the detection of clinically significant disease in standard (STD) cores versus multiparametric magnetic resonance imaging (mpMRI) targeted (TAR) cores.Material and Methods. A prospective study was conducted on 129 biopsy naïve men with clinical suspicion of prostate cancer. These patients underwent prebiopsy mpMRI with STD systematic biopsies and TAR biopsies when lesions were found. The agreement between the TAR and the STD protocols was measured using Cohen’s kappa coefficient.Results. Cancer detection rate of MRI-targeted biopsy was 62.7%. TAR protocol demonstrated higher detection rate of clinically significant disease compared to STD protocol. The proportion of cores positive for clinically significant cancer in TAR cores was 28.9% versus 9.8% for STD cores (P<0.001). The proportion of men with clinically significant cancer and the proportion of men with Gleason score 7 were higher with the TAR protocol than with the STD protocol (P=0.003;P=0.0008, resp.).Conclusion. mpMRI improved clinically significant prostate cancer detection rate compared to STD protocol alone with less tissue sampling and higher Gleason score. Further development in imaging as well as multicentre studies using the START recommendation is needed to elucidate the role of mpMRI targeted biopsy in the management of prostate cancer.

scholarly journals Systematic and MRI-Cognitive Targeted Transperineal Prostate Biopsy Accuracy in Detecting Clinically Significant Prostate Cancer after Previous Negative Biopsy and Persisting Suspicion of Malignancy

Medicina ◽  
2021 ◽  
Vol 57 (1) ◽  
pp. 57
Author(s):  
Alvydas Vėželis ◽  
Gediminas Platkevičius ◽  
Marius Kinčius ◽  
Liutauras Gumbys ◽  
Ieva Naruševičiūtė ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Prostate Biopsy ◽  
Specific Antigen ◽  
Transrectal Ultrasound ◽  
Targeted Biopsy ◽  
Negative Biopsy ◽  
Prostate Biopsies ◽  
Clinically Significant ◽  
Systematic Biopsy ◽  
Targeted Biopsies

Background and objectives: Overdiagnosis, overtreatment, and the need for repeated procedures caused by transrectal ultrasound guided prostate biopsies and their related complications places a heavy burden on healthcare systems. This was a prospective cohort validating study to access the clinical accuracy of systematic and MRI-cognitive targeted transperineal prostate biopsies in detecting clinically significant prostate cancer after a previous negative biopsy and persistent suspicion of malignancy. The primary goal was to assess the ability of multiparametric magnetic resonance imaging (mpMRI) to detect clinically significant prostate cancer with an additional goal to assess the diagnostic value of systematic and MRI-cognitive transperineal biopsies. Materials and Methods: In total, 200 patients were enrolled who had rising serum prostate specific antigen (PSA) levels for at least 4 months after a previous negative transrectal ultrasound (TRUS) biopsy. All eligible men underwent 1.5T prostate mpMRI, reported using the Prostate Imaging Reporting and Data System version 2 (PI-RADS v2), followed by a 20-region transperineal prostate systematic biopsy and additional targeted biopsies. Results: Systematic 20-core transperineal prostate biopsies (TPBs) were performed for 38 (19%) patients. Systemic 20-core TPB with additional cognitive targeted biopsies were performed for 162 (81%) patients. Clinically significant prostate cancer (csPC) was detected for 31 (15.5%) patients, of which 20 (64.5%) cases of csPC were detected by systematic biopsy, eight (25.8%) cases were detected by targeted biopsy, and three (9.7%) both by systematic and targeted biopsies. Conclusions: Cognitive mpMRI guided transperineal target biopsies increase the detection rate of clinically significant prostate cancer after a previously negative biopsy. However, in a repeat prostate biopsy setting, we recommend applying a cognitive targeted biopsy with the addition of a systematic biopsy.

scholarly journals Multiparametric MRI-Targeted TRUS Prostate Biopsies Using Visual Registration

2014 ◽  
Vol 2014 ◽  
pp. 1-11 ◽  
Author(s):  
Philippe Puech ◽  
Adil Ouzzane ◽  
Vianney Gaillard ◽  
Nacim Betrouni ◽  
Benoit Renard ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Diagnostic Yield ◽  
Transrectal Ultrasound ◽  
Multiparametric Mri ◽  
Ultrasound Guided ◽  
Prostate Biopsies ◽  
Multiparametric Prostate Mri ◽  
Clinically Significant ◽  
Prostate Cancers ◽  
Targeted Biopsies

Prebiopsy multiparametric prostate MRI (mp-MRI), followed by transrectal ultrasound-guided (TRUS-G) target biopsies (TB) of the prostate is a key combination for the diagnosis of clinically significant prostate cancers (CSPCa), to avoid prostate cancer (PCa) overtreatment. Several techniques are available for guiding TB to the suspicious mp-MRI targets, but the simplest, cheapest, and easiest to learn is “cognitive,” with visual registration of MRI and TRUS data. This review details the successive steps of the method (target detection, mp-MRI reporting, intermodality fusion, TRUS guidance to target, sampling simulation, sampling, TRUS session reporting, and quality insurance), how to optimize each, and the global indications of mp-MRI-targeted biopsies. We discuss the diagnostic yield of visually-registered TB in comparison with conventional biopsy, and TB performed using other registration methods.

scholarly journals The use of prostate MR for targeting prostate biopsies

BJR|Open ◽  
2019 ◽  
Vol 1 (1) ◽  
pp. 20180044
Author(s):  
R. Phelps Kelley ◽  
Ronald J. Zagoria ◽  
Hao G. Nguyen ◽  
Katsuto Shinohara ◽  
Antonio C. Westphalen
Keyword(s):  
Prostate Cancer ◽  
Risk Stratification ◽  
Patient Management ◽  
Transrectal Ultrasound ◽  
Multiparametric Mri ◽  
Targeted Biopsy ◽  
Advantages And Disadvantages ◽  
Prostate Biopsies ◽  
The Impact

Management of prostate cancer relies heavily on accurate risk stratification obtained through biopsies, which are conventionally performed under transrectal ultrasound (TRUS) guidance. Yet, multiparametric MRI has grown to become an integral part of the care of males with known or suspected prostate cancer. This article will discuss in detail the different MRI-targeted biopsy techniques, their advantages and disadvantages, and the impact they have on patient management.

Transperineal Versus Transrectal MRI/TRUS Fusion Targeted Biopsy: Detection Rate of Clinically Significant Prostate Cancer

2017 ◽  
Vol 15 (1) ◽  
pp. e33-e36 ◽  
Author(s):  
Pietro Pepe ◽  
Antonio Garufi ◽  
Giandomenico Priolo ◽  
Michele Pennisi
Keyword(s):  
Prostate Cancer ◽  
Detection Rate ◽  
Targeted Biopsy ◽  
Clinically Significant

scholarly journals Multiparametric MRI in Biopsy Guidance for Prostate Cancer: Fusion-Guided

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Jason T. Rothwax ◽  
Arvin K. George ◽  
Bradford J. Wood ◽  
Peter A. Pinto
Keyword(s):  
Prostate Cancer ◽  
Specific Antigen ◽  
Elevated Serum ◽  
Focal Therapy ◽  
Multiparametric Mri ◽  
Solid Organ ◽  
Prostate Biopsies ◽  
Innovative Methods ◽  
Early Phase Trials ◽  
Clinically Significant

Prostate cancer (PCa) is the most common solid-organ malignancy among American men and the second most deadly. Current guidelines recommend a 12-core systematic biopsy following the finding of an elevated serum prostate-specific antigen (PSA). However, this strategy fails to detect an unacceptably high percentage of clinically significant cancers, leading researchers to develop new, innovative methods to improve the effectiveness of prostate biopsies. Multiparametric-MRI (MP-MRI) has emerged as a promising instrument in identifying suspicious regions within the prostate that require special attention on subsequent biopsy. Fusion platforms, which incorporate the MP-MRI into the biopsy itself and provide active targets within real-time imaging, have shown encouraging results in improving the detection rate of significant cancer. Broader applications of this technology, including MRI-guided focal therapy for prostate cancer, are in early phase trials.

scholarly journals A Pilot Study of 18F-DCFPyL PET/CT or PET/MRI and Ultrasound Fusion Targeted Prostate Biopsy for Intra-Prostatic PET-Positive Lesions

2021 ◽  
Vol 11 ◽  
Author(s):  
Yachao Liu ◽  
Hongkai Yu ◽  
Jiajin Liu ◽  
Xiaojun Zhang ◽  
Mu Lin ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Targeted Biopsy ◽  
High Detection Rate ◽  
Prostate Biopsies ◽  
Signal Characteristics ◽  
Pet Ct ◽  
High Detection ◽  
Clinically Significant ◽  
Specific Membrane ◽  
Rule Out

ObjectivesThe purpose of this study was to evaluate the feasibility and diagnostic performance of prostate-specific membrane antigen (PSMA) based 18F-DCFPyL PET/CT-ultrasound (PET/CT-US) or PET/MRI-ultrasound (PET/MRI-US) fusion targeted biopsy for intra-prostatic PET-positive lesions.MethodsFrom April 2018 to November 2019, we prospectively enrolled 55 candidates to perform PET/CT-US or PET/MRI-US fusion targeted biopsies for solitary PET-positive prostate lesions (two to four cores/lesion). The positive rates of prostate cancer based on patients and biopsy cores were calculated respectively. With reference to the pathological results of biopsy cores, the MR signal characteristics in the area of the PET-positive lesion were analyzed for the patients who underwent PET/MRI.ResultsA total of 178 biopsy cores were taken on the 55 patients. One hundred forty-six biopsy cores (82.0%, 146/178) from 51 (92.7%, 51/55) patients were positive for prostate cancer; 47 (85.5%, 47/55) were clinically significant prostate cancer. It is noteworthy that nine patients underwent both 18F-DCFPyL PET/CT and PET/MRI examinations; the seven patients with prostate cancer showed abnormal MR signal in the area of the PET-positive lesion while the other two patients with prostatic hyperplasia and prostatitis showed normal MR signal in the area of the PET-positive lesion.ConclusionThis study indicated that 18F-DCFPyL PET/CT-US or PET/MRI-US fusion targeted prostate biopsies may be valuable for prostate cancer diagnosis and have a high detection rate of clinically significant prostate cancer for PET-positive lesions. PET/MR can rule out some false PET-positive lesions, which may potentially reduce unnecessary prostate biopsies.

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