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 Magnetic resonance/ultrasound fusion targeted biopsy of the prostate can be improved by adding systematic biopsy

2021 ◽  
Author(s):  
Victor Mihail Cauni ◽  
Dan Stanescu ◽  
Florin Tanase ◽  
Bogdan Mihai ◽  
Cristian Persu
Keyword(s):  
Prostate Cancer ◽  
Magnetic Resonance ◽  
Cancer Detection ◽  
Detection Rate ◽  
Specific Antigen ◽  
Cancer Detection Rate ◽  
Targeted Biopsy ◽  
Detection Rates ◽  
Clinically Significant ◽  
Systematic Biopsy

Aim: Magnetic resonance/ ultrasound fusion targeted biopsy (Tbs) is widely used for diagnosing prostate cancer (PCa). The aim of our study was to compare the cancer detection rate (CDR) and the clinically significant prostate cancer detection rate (csPCa) of the magnetic resonance/ultrasound fusion targeted biopsy with those of the standard systematic biopsy (Sbs) and of the combination of both techniques.Material and methods: A total of 182 patients underwent magnetic resonance/ultrasound fusion Tbs on the prostate for PCa suspicion based on multiparametric magnetic resonance imaging (mMRI) detection of lesions with PI-RADSv2 score ≥3. A total of 78 patients had prior negative biopsies. Tb was performed by taking 2-4 cores from each suspected lesion, followed by Sb with 12 cores. We evaluated the overall detection rate of PCa and clinically significant prostate cancer, defined as any PCa with Gleason score ≥3+4.Results: Median prostate specific antigen (PSA) level pre-biopsy was 7.4 ng/ml and median free-PSA/PSA ratio was 10.2%. Patient median age was 62 years old. PIRADSv2 score was 3 in 54 cases, 4 in 96 cases and 5 in 32 cases. PI-RADS-dependent detection rate of Tbs for scores 3, 4 and 5 was 25.9%, 65.6% and 84.4%, respectively, with csPCa detection rates of 24.1%, 54.2%, and 71.9%. Overall detection rate was 57.1% for Tbs, which increased to 60.4% by adding Sbs results. Detection rate for clinically significant prostate cancer (csPCa) was 48.4% and increased to 51.1% by adding Sbs. Overall detection rate for repeated biopsy was 50% and 68.3% for biopsy in naïve patients. Sbs detection rate was 55.5%, 8 patients having a negative biopsy on Tbs.Conclusions: When Tbs is considered due to a PI-RADS ≥3 lesion on mMRI, combined Tbs + Sbs increases the overall CDR and csPCa detection rates.

scholarly journals 3D versus 2D Systematic Transrectal Ultrasound-Guided Prostate Biopsy: Higher Cancer Detection Rate in Clinical Practice

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Alexandre Peltier ◽  
Fouad Aoun ◽  
Fouad El-Khoury ◽  
Eric Hawaux ◽  
Ksenija Limani ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Detection ◽  
Prostate Biopsy ◽  
Detection Rate ◽  
Transrectal Ultrasound ◽  
Daily Practice ◽  
Cancer Detection Rate ◽  
Prior History ◽  
Detection Rates ◽  
Significant Difference

Objectives. To compare prostate cancer detection rates of extended 2D versus 3D biopsies and to further assess the clinical impact of this method in day-to-day practice.Methods. We analyzed the data of a cohort of 220 consecutive patients with no prior history of prostate cancer who underwent an initial prostate biopsy in daily practice due to an abnormal PSA and/or DRE using, respectively, the classical 2D and the new 3D systems. All the biopsies were done by a single experienced operator using the same standardized protocol.Results. There was no significant difference in terms of age, total PSA, or prostate volume between the two groups. However, cancer detection rate was significantly higher using the 3D versus the 2D system, 50% versus 34% (P<0.05). There was no statistically significant difference while comparing the 2 groups in term of nonsignificant cancer detection.Conclusion. There is reasonable evidence demonstrating the superiority of the 3D-guided biopsies in detecting prostate cancers that would have been missed using the 2D extended protocol.

scholarly journals Extended 14-core schematic diagram mapping prostate biopsy increases both the cancer detection rate and the accuracy of Gleason Score

10.52786/a.11 ◽  
2020 ◽  
Vol 41 (2) ◽  
pp. 75-80
Author(s):  
Krittin Naravejsaku ◽  
Bhapapak Na song-kha ◽  
Wiroj Raksakul ◽  
Thitiwat Wongumpornwat ◽  
Umaphorn Nuanthaisong
Keyword(s):  
Prostate Cancer ◽  
Gleason Score ◽  
Cancer Detection ◽  
Prostate Biopsy ◽  
Detection Rate ◽  
Elevated Serum ◽  
Cancer Detection Rate ◽  
Schematic Diagram ◽  
Group I ◽  
Group Ii

Objective: To evaluate the effectiveness of extended 14-core schematic diagram mapping prostate biopsy for improving the cancer detection rate (CDR) and accuracy of Gleason score. Material and Method: This study included 184 patients who underwent transrectal ultrasound (TRUS)-guided lateral sextant biopsy (group I) and 196 patients who underwent extended 14-core biopsy (group II). Inclusion criteria for prostate biopsy were elevated serum prostate-specific antigen (PSA) levels (>4.0 ng/ml) and/or suspicious digital rectal examination (DRE). Results: Median patient age was 69.68 years (±7.89) and 70.07 years (±8.83) for group I and II, respectively. Median pre-biopsy PSA was 18.04 (range: 8.42-22.35) and 15.83 ng/ml (range: 6.54-21.72) for group I and II. Out of the first group, 65 (35.3%) patients had prostate cancer, whereas 78 (40.0%) patients of group II had cancers. The overall cancer detection rate was significantly higher in group II (40.0%) than group I (35.3%), p=0.034, and in particular showed a significant increase in the cancer detection rate in the subgroup with PSA level between 4-10 ng/ml. Moreover, rising Gleason sum after radical prostatectomy was 1 in 3 (11.1%) patients and 2 in 1 (3.7%) patient. Conclusion: Extended 14-core schematic diagram mapping prostate biopsy significantly increased the cancer detection rate of prostate cancer and increased the accuracy of biopsy Gleason score. Thus, schematic diagram mapping prostate biopsy should be the standard ultrasound guided prostate biopsy in our institute for increasing the cancer detection rate and also for planning treatments.

Pathologic outcomes of MRI invisible tumors in prostate cancer.

2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 282-282
Author(s):  
Sandeep Gurram ◽  
Amir H. Lebastchi ◽  
Michael Ahdoot ◽  
Alex Z. Wang ◽  
Bradford J. Wood ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Detection ◽  
Detection Rate ◽  
Transrectal Ultrasound ◽  
Cancer Detection Rate ◽  
Diagnostic Challenge ◽  
Fusion Biopsy ◽  
Sextant Biopsy ◽  
Magnetic Resonance Imaging Mri ◽  
Over Time

282 Background: Magnetic resonance imaging (MRI) invisible tumors are a diagnostic challenge in prostate cancer due to the lack of ability to reliably monitor these lesions radiographically or pathologically. The progression and natural history of these lesions are unknown and outcomes over time are unclear. Methods: Men with multiparametric MRI of the prostate and MRI/Transrectal ultrasound (TRUS) fusion guided biopsy were assessed for the presence of MRI invisible tumors (MIT). An MIT is defined as cancer detected only on extended sextant biopsy and not visible on MRI. All men first underwent an MRI/TRUS fusion biopsy with tracked extended sextant biopsy which originally detected the MIT. The original biopsy needle course sampling these MITs was tracked and set as a future target using the MRI/TRUS fusion platform. Men subsequently underwent a combined MRI/TRUS fusion biopsy, systematic extended sextant biopsy, and a Targeted Tracked biopsy of the MIT (TT-MIT) that was recorded and tracked from the original biopsy. We describe the outcomes of tracking these MITs and compare the ability to monitor them with TT-MIT biopsy as opposed to systematic extended sextant biopsy. Results: 105 MITs were identified, 84 (80%) of which were originally Gleason 6 tumors. The median time between biopsies was 16.6 months. The overall cancer detection rate with TT-MIT was 77.4% compared to 59.7% using systematic extended sextant biopsy. Using TT-MIT, these invisible tumors showed higher Gleason scores in 16 (15.2%) tumors. When TT-MIT was compared to the systematic extended sextant biopsy sampling the corresponding location, it showed increased Gleason scores in 30 (28.6%) MITs while 58 (55.2%) showed concordant pathology and 17 (16.2%) showed less aggressive pathology. Conclusions: The ability to follow MRI invisible tumors suggests that these tumors are more effectively tracked using TT-MIT biopsy technique. These MITs change over time and 15% of them will upgrade to higher Gleason scores. Tracking these tumors with TT-MIT biopsy increases cancer detection rate compared to standard sextant biopsy and more accurately samples these MITs, unveiling a more aggressive pathology.

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.

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