Prostate Volume Index and Chronic Inflammation of the Prostate Type IV with Respect to the Risk of Prostate Cancer

2014 ◽  
Vol 94 (3) ◽  
pp. 270-285 ◽  
Author(s):  
Antonio B. Porcaro ◽  
Giovanni Novella ◽  
Alberto Molinari ◽  
Alessandro Terrin ◽  
Anila Minja ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Prostate Volume ◽  
Specific Antigen ◽  
Transrectal Ultrasound ◽  
Normal Growth ◽  
Peripheral Zone ◽  
Transitional Zone ◽  
Growth Patterns ◽  
Volume Index ◽  
Type Iv

Background: Benign prostatic hyperplasia and prostate cancer (PCA) alter the normal growth patterns of zonal anatomy with changes of prostate volume (PV). Chronic inflammatory infiltrates (CII) type IV are the most common non-cancer diagnosis of the prostate after biopsy. Objective: To evaluate associations of both PV index (PVI), i.e. the ratio of transitional zone volume (TZV) to peripheral zone volume (PZV), and CII with PCA in patients undergoing biopsy. Subjects and Methods: Between January 2007 and December 2008, 268 consecutive patients who underwent prostate biopsy were retrospectively evaluated. PV and TZV were measured by transrectal ultrasound. PZV was computed by subtracting the PV from the TZV. CII were evaluated according to standard criteria. Significant associations of PVI and the presence of CII (CII+) with PCA risk were assessed by statistical methods. Results and Limitations: We evaluated 251 patients after excluding cases with painful rectal examinations, prostate-specific antigen (PSA) >20 μg/ml and metastases. The PCA detection rate was 41.1%. PVI was a negative independent predictor of PCA. A PVI ≤1.0 was directly [odds ratio (OR) = 2.36] associated with PCA, which was detected more frequently in patients with a PVI ≤1.0 (29.1%) than in those with a PVI >1.0 (11.9%). CII+ was inversely (OR = 0.57) and independently associated with PCA, which was detected less frequently in cases with CII (9.9%) than in those without CII (21.1%). Potential study limitations might relate to the fact that PV was not measured by prostatectomy specimens and there was PSA confounding for CII and PCA. Conclusions: Low values of PVI are directly associated with risk of PCA, which was almost 2.5 times higher in patients with a PVI ≤1.0. The PVI might be an effective parameter for clustering patients at risk of PCA. CII+ was inversely associated with risk of PCA and decreased the probability of detecting PCA by 43%. The role of the PVI and CII in PCA carcinogenesis needs further research.

Prostate Volume Index Stratified Prostate Cancer Risk in Patients Elected to a First Random Biopsy Set

2017 ◽  
Vol 103 (4) ◽  
pp. 374-379 ◽  
Author(s):  
Antonio B. Porcaro ◽  
Paolo Corsi ◽  
Nicolò de Luyk ◽  
Marco Sebben ◽  
Alessandro Tafuri ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Goodness Of Fit ◽  
Prostate Volume ◽  
Digital Rectal Examination ◽  
Prostate Cancer Risk ◽  
Peripheral Zone ◽  
Transitional Zone ◽  
Volume Index ◽  
Multivariate Logistic Regression Model ◽  
Random Biopsy

Objective To investigate prostate volume index (PVI), defined as the ratio of volume of the transitional zone on that of the peripheral zone, as a factor stratifying prostate cancer (PCA) risk in patients elected to a first random biopsy set. Methods The study evaluated 596 patients who were elected to a first random biopsy set because of suspected PCA in a period between September 2010 and September 2015. Prostate volume index was dichotomized to PVI ≤1 vs PVI >1. The multivariate logistic regression model investigated clinical factors with dichotomized PVI associating with PCA. Results The detection rate of PCA was 49%. The dichotomized PVI >1 stratified PCA risk (odds ratio [OR] 0.455; p<0.0001) beyond age (OR 1.062; p<0.0001), PSA (OR 1.167; p<0.0001), PV (OR 0.957; p<0.0001), and abnormal digital rectal examination (OR 2.094; p<0.0001). The goodness of fit statistics assessed model efficacy. Conclusions A large cohort of patients elected to a first random biopsy set had PCA risk stratified by dichotomized PVI beyond other clinical independent factors. Confirmatory studies are required.

scholarly journals Importance of prostate volume for detection of prostate cancer by first sextant biopsy in high-risk patients

Medicina ◽  
2007 ◽  
Vol 43 (4) ◽  
pp. 285 ◽  
Author(s):  
Kęstutis Vaičiūnas ◽  
Stasys Auškalnis ◽  
Aivaras Matjošaitis ◽  
Darius Trumbeckas ◽  
Mindaugas Jievaltas
Keyword(s):  
Prostate Cancer ◽  
High Risk ◽  
Transition Zone ◽  
Prostate Biopsy ◽  
Prostate Volume ◽  
Specific Antigen ◽  
Digital Rectal Examination ◽  
Transitional Zone ◽  
Antigen Level ◽  
Sextant Biopsy

The aim of this study was to evaluate the relevance of prostate gland volume, transitional zone volume, and transitional zone index for the detection of prostate cancer by the first sextant biopsy. Material and methods. A total of 121 men with high risk of prostate cancer were included in our study (prostate-specific antigen level higher than 4 ng/mL and/or pathological digital rectal examination). We consulted the patients in Outpatient Department of Kaunas University of Medicine Hospital during 2003–2006. Total prostate volume and transition zone volume were measured, and all patients underwent transrectal ultrasoundguided sextant biopsy of the prostate. According to histological results of prostate biopsy, patients were divided into two groups: benign group (benign prostate hyperplasia and high-grade intraepithelial neoplasia) and prostate cancer group. Statistical analysis was made by SPSS (Statistical Package for Social Sciences) 12.0.1 for Windows. Results. After histological examination, prostate cancer was detected in 20.7% of patients (n=25). Prostate cancer was found in 24.6% of patients with a total prostate volume of less than 60 cm3 and only in 8.2% of patients with a total prostate volume greater than 60 cm3 (P=0.026). Prostate cancer was found in 27.1% of patients with transition zone volume smaller than 30 cm3 and only in 7.5% of patients with transition zone volume greater than 30 cm3 (P=0.007). A statistically significant difference was found when patients were divided into the groups according to transition zone index: when transition zone index was lower than 0.45, prostate cancer was detected in 37.1% of patients, and when transition zone index was higher than 0.45, prostate cancer was observed in 9.1% of patients (P=0.001). The possibility to detect prostate cancer was 5.9 times higher in patients with transition zone index lower than 0.45. Conclusions. Prostate cancer detection rate by first sextant prostate biopsy in patients with elevated prostate-specific antigen level and/or pathological digital rectal examination was higher when total prostate volume was less than 60 cm3, transition zone was less than 30 cm3, and transition zone index was less than 0.45.

scholarly journals Effect on prostatic specific antigen by a short time treatment with a Curcuma extract: A real life experience and implications for prostate biopsy

2018 ◽  
Vol 90 (2) ◽  
pp. 107 ◽  
Author(s):  
Andrea Fabiani ◽  
Carolina Morosetti ◽  
Alessandra Filosa ◽  
Emanuele Principi ◽  
Luca Lepri ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Life Experience ◽  
Prostate Volume ◽  
Specific Antigen ◽  
Transrectal Ultrasound ◽  
Real Life ◽  
Prostatic Biopsy ◽  
Screening Programs ◽  
Total Psa ◽  
Total Ratio

Introduction and objectives: PSA elevation is associated with prostate cancer and it is used in screening programs for its diagnosis. It is one of the most common indications for referral to an urologist. There’s no consensus about what to do in PSA elevation management. Antibiotics, nutraceuticals or anti-inflammatories are commonly prescribed in daily practice. Our objective was to verify the effect on the PSA value of a short 30-day trial of a curcuma extract, than to discuss the implications in terms of reducing the number of prostate biopsies performed. Patients and methods: We enrolled 50 consecutive patients admitted at our attention for a first PSA over the level of 4 ng/ml or for a suspected PSA rising defined as PSA velocity (PSAv) > 0.75 ng/ml/years. They received treatment with curcuma extract, 2 tablets per day for 30 day. All patients received a second PSA measurement and TRUS within 6 days from the end of the therapy. In case of PSA reduction below 4 ng/ml, patients were reassured and invited to repeat a PSA control over the time. When PSA level were persistently high over 4 ng/ml or in case of any rising, patients underwent a transrectal ultrasound guided 12-core prostatic biopsy (TRUSbx). Results: Mean age of the patients was 64.56 ± 8.88 (range, 42- 81 years). Prostate volume was 48.34 ± 15,77 ml (range, 18-80 ml). At visit 1, PSA value was in mean 6,84 ± 3.79 ng/ml (range 2.93-21ng/ml). Consequently, mean PSA density value was 0.16 ± 0.16 (range 0.05-1.11). PSA free and PSA total ratio at baseline was 16.85 ± 3.9% (range 8-26%). At visit 2, the prostate volume did not change. Total PSA was 4.65 ± 2,67 ng/ml (range 1-16.82 ng/ml). PSA free and PSA total ratio (PSAF/T) after treatment was 19.68 ± 5.35 % (range 7.8-29%). The differences of total PSA and PSAF/T between visit 1 and visit 2 were < 0.0001 and p < 0.0036, respectively. We performed 26 TRUSbx. Prostate cancer was diagnosed in 6 cases, PIN HG in 2 cases and non neoplastic findings in the remnants 18 patients. Conclusions: Use of the Curcuma extract is able to lower the PSA value after a 30-day intake period. We are not able to state that the reduction of PSA after intake of this Curcuma extract may exclude a prostate cancer. We need further studies to evaluate that.

scholarly journals The diagnostic value of a new formula combining age and prostate volume in prostate cancer

2021 ◽  
Keyword(s):  
Prostate Cancer ◽  
Linear Model ◽  
Prostate Volume ◽  
Specific Antigen ◽  
Transrectal Ultrasound ◽  
High Sensitivity ◽  
Roc Curves ◽  
Diagnostic Value ◽  
Number Of Patients ◽  
Log Linear

Background and objective: This study combined two clinical indicators (age and prostate volume (PV)) to generate age to PV (AVR) ratio, whose diagnostic value for prostate cancer (PCa) was examined based on prostate specific antigen (PSA) in the range of 4--20.0 ng/mL. Methods: The medical records of patients who underwent transrectal ultrasound-guided biopsy of the prostate in our hospital from June 2015 to June 2019 were examined retrospectively. According to the pathological results of the biopsy, the patients were divided into the PCa and benign prostatic hyperplasia (BPH) groups. Receiver operating characteristic (ROC) curves for TPSA, PSAD, PV, (F/T)PSA, AVR, and PSA-AV were plotted with SPSS 26.0 and GraphPad Prism 5.0, and areas under the ROC curves (AUROCs) were determined and compared by Delong test. A log-linear model was used to compare AVR and other parameters with similar high sensitivities, for specificity. Results: The AUROC for AVR was significantly different from those of TPSA (p < 0.001), PV (p = 0.004),(F/T)PSA (p < 0.001), and PSA-AV (p = 0.006), and similar to that of PSAD (p = 0.064). With the same high sensitivity (90.0%), log-linear model analysis showed that the specificity of AVR was significantly higher than those of TPSA and (F/T)PSA (p < 0.01), while there were no significant differences among AVR and PSAD, PV and PSA-AV. Conclusion: With PSA in the range of 4--20.0 ng/mL, AVR may be useful in sparing an invasive intervention for a number of patients.

scholarly journals Prostatic calculi detected in peripheral zone of the gland during a transrectal ultrasound biopsy can be significant predictors of prostate cancer

2016 ◽  
Vol 88 (4) ◽  
pp. 304 ◽  
Author(s):  
Lucio Dell’Atti ◽  
Andrea B. Galosi ◽  
Carmelo Ippolito
Keyword(s):  
Prostate Cancer ◽  
Transrectal Ultrasound ◽  
Central Zone ◽  
Peripheral Zone ◽  
Transitional Zone ◽  
Gleason Grade ◽  
Significant Difference ◽  
Significant Area ◽  
A Prospective Study ◽  
Prostatic Inflammation

Purpose: Prostatic calculi (PC) are usually associated with benign prostatic hyperplasia or chronic inflammation. However, in several studies prostatic inflammation and calcification have been implicated in the pathogenesis of prostate cancer (CaP). We evaluated the prevalence of PC during transrectal ultrasound (TRUS) and correlate the ultrasonographic patterns with histological findings. Methods: A prospective study of 664 patients undergoing TRUS and prostate biopsy was planned. A standardized reproducible technique was used with using a GE Logiq 7 machine equipped with a 5-9MHz multi-frequency convex probe “end-fire”. We defined marked presence of PC as multiple hyperechoic foci with significant area (≥ 3 mm in the largest diameter). PC were classified according to zone distribution into the gland: transitional zone (TZ), central zone (CZ), and peripheral zone (PZ). Results: No significant difference was noted between the patients with PC and without PC, when comparing age, preoperative PSA level, prostate volume, and biopsy number, except for DRE findings. 168 patients (25.3%) had marked presence of PC on TRUS: 50.6% in TZ, 20.2% in CZ, and 29.2% in PZ. 31 patients (63.3%) with presence of PC in PZ had CaP on biopsy. The correlation observed between CaP and the presence of PC in PZ was statistically significant (p &lt; 0.001). However, among patients in the CaP group there was no statistical association between PC and moderate or high Gleason grade. Conclusions: This study suggests that chronic prostatic inflammation and PC have a role in the biogenesis of cancer. CaP was more frequent in patients with PC in PZ of the gland, but was not associated with higher Gleason grade among these patients (p &lt; 0.001).

scholarly journals Relationship between serum prostate-specific antigen and transrectal prostate sonographic findings in asymptomatic Ugandan males

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Maxwell Okuja ◽  
Faith Ameda ◽  
Henry Dabanja ◽  
Felix Bongomin ◽  
Samuel Bugeza
Keyword(s):  
Prostate Cancer ◽  
Prostate Specific Antigen ◽  
Specific Antigen ◽  
Transrectal Ultrasound ◽  
Correlation Coefficients ◽  
Peripheral Zone ◽  
Age Group ◽  
Adult Males ◽  
Serum Prostate Specific Antigen ◽  
Benign Nodules

Abstract Background Prostate disorders are among the leading causes of morbidity and mortality in men above the age of 40 years globally. Serum prostate-specific antigen (PSA) levels may be used to screen men at risk of prostate cancer and determine choice of medical treatment in benign prostatic hyperplasia (BPH) and evaluation of patients with prostatitis, while prostate sonography determines prostate volume (PV) and detects nodules. BPH may exhibit distinct hypoechoic, isoechoic, or hyperechoic nodules in the transition zone, whereas hypoechoic nodules in the peripheral zone are diagnostic for prostate cancer in over 50% of cases. In this study, we aimed at determining the relationship between serum PSA levels and transrectal prostate sonographic findings among asymptomatic Ugandan males. Methods Ugandan males above 30 years of age or older without lower urinary tract symptoms were cross-sectionally enrolled into the study. Serum PSA determination and transrectal ultrasound were performed. Association between PSA levels and PV was assessed using Spearman’s correlation coefficients (ρ). Results A total of 277 men were studied. The median serum PSA level was 1 (95% CI: 1–2). Most (n = 217, 78.3%) participants had serum PSA levels ≤ 4 ng/ml. The median sonographic PV was 26 (95% CI: 26–29) mls. One hundred and fifty-five (56.0%) participants had PV between 25 and 50 mls. Both PSA levels and PV progressively increased with age from 0.9 ng/ml and 22 mls in the 30–39 year age group to 7 ng/ml and 38 mls in the 60–69 year age group, respectively. PSA levels weakly correlated with PV (ρ = 0.27) (p < 0.0001). One hundred and thirty (47%) participants had prostatic nodules. Of these, 100 (77%) had features of benign nodules and 23% had suspicious nodules for prostate cancer. The median (range) serum PSA level in those with nodules was 2.0 (0.1–16.0) ng/ml and for those without nodules was 1.1 (0.1–8.0) ng/ml (p < 0.0001). Conclusions Serum PSA has a weak direct correlation with PV and not a reliable marker for the prediction of presence or absence of prostatic nodules in asymptomatic adult males.

Clinical Usefulness of Prostate Specific Antigen and Prostate Specific Antigen Density to Distinguish Benign from Malignant Prostate Diseases

1994 ◽  
Vol 61 (4) ◽  
pp. 289-293
Author(s):  
C. Terrone ◽  
E. Vestita ◽  
A. Formigoni ◽  
S. Rocca Rossetti ◽  
G. Aimo
Keyword(s):  
Prostate Cancer ◽  
Prostate Specific Antigen ◽  
Prostate Volume ◽  
Specific Antigen ◽  
Transrectal Ultrasound ◽  
Three Dimensions ◽  
Surgical Specimen ◽  
Prostate Specific Antigen Density ◽  
Prostate Diseases ◽  
Malignant Prostate

The possibility of distinguishing prostate cancer from BPH with the prostate specific antigen (PSA) determination is particularly poor when PSA levels are between 4.1 and 10 ng/ml. In these cases the quotient of serum PSA and prostate volume, defined as prostate specific antigen density (PSAD), seems to enhance the accuracy of PSA alone. In this study we evaluated retrospectively the preoperative PSA levels in 139 patients with BPH and in 26 patients with prostate cancer who underwent surgical treatment at our Department. We calculated the prostate volume with the following formula: length x width x depth x 0.52. The three dimensions were obtained from the surgical specimen in the patients with prostate cancer and using transrectal ultrasound in the cases of BPH. In patients with a serum PSA level of 4.1 to 10 ng/ml, PSA alone was not able to distinguish benign from malignant prostate disease; the PSAD values, on the contrary, provided a statistically significant (p < 0.003) stratification between BPH and prostate cancer (mean PSAD of 0.0088 and 0.191 respectively). Only 6% of patients with BPH had a PSAD greater than 0.15 compared to 76% of patients with prostate cancer. These results suggest the usefulness of PSAD in predicting the presence of prostate cancer in patients with intermediate levels of serum PSA.

scholarly journals Prostate volume index and prostatic chronic inflammation have an effect on tumor load at baseline random biopsies in patients with normal DRE and PSA values less than 10 ng/ml: results of 564 consecutive cases

2019 ◽  
Vol 11 ◽  
pp. 175628721986860 ◽  
Author(s):  
Antonio B. Porcaro ◽  
Alessandro Tafuri ◽  
Marco Sebben ◽  
Aliasger Shakir ◽  
Giovanni Novella ◽  
...  
Keyword(s):  
Chronic Inflammation ◽  
Prostate Volume ◽  
Specific Antigen ◽  
Peripheral Zone ◽  
Volume Index ◽  
Multivariate Models ◽  
Central Transition ◽  
Positive Biopsy ◽  
Tumor Load ◽  
Caucasian Patients

Background: To assess the association of prostate volume index (PVI), defined as the ratio of the central transition zone volume (CTZV) to the peripheral zone volume (PZV), and prostatic chronic inflammation (PCI) as predictors of prostate cancer (PCA) load in patients presenting with normal digital rectal exam (DRE) and prostate-specific antigen (PSA) ⩽ 10 ng/ml at baseline random biopsies. Methods: Parameters evaluated included age, PSA, total prostate volume (TPV), PSA density (PSAD), PVI and PCI. All patients underwent 14 core transperineal randomized biopsies. We considered small and high PCA load patients with no more than three (limited tumor load) and greater than three (extensive tumor load) positive biopsy cores, respectively. The association of factors with the risk of PCA was evaluated by logistic regression analysis, utilizing different multivariate models. Results: 564 Caucasian patients were included. PCA and PCI were detected in 242 (42.9%) and 129 (22.9%) cases, respectively. On multivariate analysis, PVI and PCI were independent predictors of the risk of detecting limited or extensive tumor load. The risk of detecting extensive tumor load at baseline biopsies was increased by PSAD above the median and third quartile as well as PVI ⩽ 1 [odds ratio (OR)=1.971] but decreased by PCI (OR=0.185; 95% CI: 0.088–0.388). Conclusions: Higher PVI and the presence of PCI predicted decreased PCA risk in patients presenting with normal DRE, and a PSA ⩽ 10 ng/ml at baseline random biopsy. In this subset of patients, a PVI ⩽ or >1 is able to differentiate patients with PCA or PCI.

scholarly journals Kezdeti tapasztalataink az mpMR fúziós ultrahangvezérelt prosztatabiopsziával

2020 ◽  
Vol 161 (52) ◽  
pp. 2188-2194
Author(s):  
András Béla Hüttl ◽  
Dávid Ádám Korda ◽  
M. Zsuzsanna Lénárd ◽  
Attila Szendrői ◽  
Gábor Rudas ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Detection Rate ◽  
Prostate Volume ◽  
Cost Effective ◽  
Peripheral Zone ◽  
Transitional Zone ◽  
Lesion Size ◽  
Fusion Biopsy ◽  
Extraprostatic Extension ◽  
Targeted Biopsies

Összefoglaló. Bevezetés: A prosztatarák diagnosztikájában az utóbbi években paradigmaváltás történt. Az MR-vizsgálat fejlődése lehetővé tette a prosztatatumor gyanús elváltozásainak célzott mintavételét. Az mpMR fúziós biopszia pontos és költséghatékony módszer. Célkitűzés: Célkitűzésünk az volt, hogy összegezzük az mpMR fúziós biopsziák terén szerzett tapasztalatainkat. Módszer: A Semmelweis Egyetem Urológiai Klinikáján 2017 és 2019 között 40, mpMR fúziós biopsziát végeztünk a BioJet-program segítségével, transperinealis behatolásból. Az MR-vizsgálatok kiértékelése a PI-RADS v2 ajánlása szerint történt. Megvizsgáltuk, hogy a laesiók PI-RADS-besorolása, elhelyezkedése, mérete, az extraprosztatikus terjedés jeleinek megléte, a páciensek PSA-, illetve PSAD-értékei, valamint a prosztata volumene befolyásolja-e a mintavételek kimenetelét. Eredmények: A célzott mintavételek során pácienseink 80%-ánál igazolódott malignitás. PI-RADS 5. és 4. besorolású laesiók esetén a detektációs ráta 91%, illetve 85%, míg PI-RADS 3. laesióknál 20% volt. A perifériás zóna elváltozásainál szignifikánsan magasabb volt a pozitív eredmény valószínűsége, mint a tranzicionális zóna laesióinál (khi2(1) = 6,555, p = 0,010, Fisher-féle egzakt p = 0,017, V = 0,355). Az extraprosztatikus terjedés jelei és a magasabb PSAD-értékek növelték a pozitív minták valószínűségét (khi2(1) = 7,704, p = 0,006, Fisher-féle egzakt p = 0,004, V = 0,355; illetve 0,47 ± 0,50 ng/ml2 vs. 0,18 ± 0,17 ng/ml2; Z = 3,447, p<0,001), míg az elváltozások mérete nem befolyásolta a kimenetelt. A prosztatavolumen szignifikánsan magasabb volt azoknál, akiknél nem igazolódott malignitás (50,9 ± 18,8 ml vs. 119,6 ± 91,6 ml; Z = –3,505, p<0,001). Következtetések: Az elvégzett fúziós biopsziák detektációs rátája magasabb volt az irodalmi átlagnál. Eredményeink alapján a mintavételek kimenetelét befolyásolhatja az elváltozások PI-RADS-besorolása, elhelyezkedése, az extraprosztatikus terjedés, a PSAD-értékek, valamint a prosztatatérfogat. A fenti szempontok figyelembevételével kiválaszthatók azok a páciensek, akik a legtöbbet profitálhatnak a beavatkozásból. Orv Hetil. 2020; 161(52): 2188–2194. Summary. Introduction: The past decade has seen some major changes in the diagnostics of prostate cancer. Progress in MR imaging has allowed us to better visualise prostate cancer and thus perform targeted biopsies of tumour suspect lesions. mpMRI-ultrasound fusion-guided prostate biopsy is a precise and cost-effective method to diagnose prostate cancer. Objective: The purpose of this study was to summarise our results in mpMRI-ultrasound fusion biopsy between 2017 and 2019 and compare them with the findings in the current literature. Method: Between 2017 and 2019, fully 40, mpMRI-ultrasound fusion biopsies were performed transperineally using the BioJet fusion system at Semmelweis University Urology Clinic. The MRI evaluations were done in line with the PI-RADS v2 guidelines. It was analysed whether the PI-RADS score, the location of the tumour, lesion size, the signs of extraprostatic extension, PSA/PSAD density and prostate volume have an influence on the outcome of mpMRI-ultrasound fusion biopsy. Results: Prostate cancer was diagnosed in 80% of the cases during targeted biopsies. The detection rate was 91%, 85%, and 20% for PI-RADS 5, 4 and 3 lesions, respectively. The detection rate was significantly higher for lesions located at the peripheral zone compared to the ones in the transitional zone (khi2(1) = 6.555, p = 0.010, Fisher-exact p = 0.017, V = 0.355). Signs of extraprostatic extension and higher PSAD correlated with better detection rate (khi2(1) = 7.704, p = 0.006, Fisher-exact p = 0.004, V = 0.355; and 0.47 ± 0.50 ng/ml2 vs. 0.18 ± 0.17 ng/ml2; Z = 3.447, p<0.001, respectively). The size of the lesions did not influence the outcome. The analysis showed a significant correlation between large prostate volumes and negative biopsies (50.9 ± 18.8 ml vs. 119.6 ± 91.6 ml; Z= –3.505, p<0.001). Conclusions: The detection rate of prostate cancer with targeted biopsies was higher than the data found in the international literature. The PI-RADS score, the location of the tumour, MRI signs of extraprostatic extension, PSAD and prostate volume had an influence on the detection rate. Our findings may promote a better selection of the best candidates for targeted biopsies in the future. Orv Hetil. 2020; 161(52): 2188–2194.

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