scholarly journals Histology results of systematic prostate biopsies by in-bore magnetic resonance imaging vs. transrectal ultrasound

2020 ◽  
Vol 15 (5) ◽  
Author(s):  
Alon Lazarovich ◽  
Gil Raviv ◽  
Yael Laitman ◽  
Orith Portnoy ◽  
Orit Raz ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Prostate Biopsy ◽  
Specific Antigen ◽  
Transrectal Ultrasound ◽  
Digital Rectal Examination ◽  
Resonance Imaging ◽  
Rectal Examination ◽  
Number Of Patients ◽  
Clinically Significant

Introduction: We aimed to compare systematic biopsies (SBs) of in-bore magnetic resonance-guided prostate biopsy (MRGpB) with those performed under transrectal ultrasound (TRUS) guidance in the clinical setting. Methods: Data on all 161 consecutive patients undergoing prostate biopsy in our institution between November 2017 and July 2019 were retrospectively collected. The patients were referred to biopsy due to elevated prostate-specific antigen (PSA) and/or abnormal digital rectal examination and/or at least one Prostate Imaging Reporting and Data System (PI-RADS) lesion score of ≥3 on multiparametric magnetic resonance imaging (mpMRI). We included patients with PSA levels ≤20 ng/ml and those with 8–12 core biopsies. Histology results of SBs performed by in-bore MRGpB were compared to TRUS SBs. Chi-squared, Fischer’s exact, and multivariate Pearson regression tests were used for statistical analysis (SPSS, IBM Corporation). Results: In total, 128 patients were eligible for analysis. Their median age was 68 years (interquartile range [IQR] 61.5–72), mean prostate size 55±29 cc, and mean PSA and PSA density levels 7.6±3.5 ng/ml and 0.18±0.13 ng/ml/cc, respectively. Thirty-five patients (27.3%) had suspicious digital rectal examination findings. Both biopsy groups were similar for these parameters. Thirty-eight (62.3%) MRGpB patients had a previous biopsy vs. 5 (7.1%) TRUS-SB patients (p<0.0001). The number of patients diagnosed with clinically significant and non-significant disease was similar for both groups. High-risk disease was more prevalent in the TRUS-SB group (22.4% vs. 4.9%, p<0.01). Conclusions: Our data suggest that in-bore MRGpB is no better than TRUS for guiding SBs for the detection of clinically significant prostate cancer.

One-year experience of government-funded magnetic resonance imaging prior to prostate biopsy: A case for omitting biopsy in men with a negative magnetic resonance imaging

2021 ◽  
pp. 205141582110043
Author(s):  
Hanna J El-Khoury ◽  
Niranjan J Sathianathen ◽  
Yuxin Jiao ◽  
Reza Farzan ◽  
Dennis Gyomber ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Prostate Cancer ◽  
Magnetic Resonance ◽  
Prostate Biopsy ◽  
Multivariable Analysis ◽  
Transrectal Ultrasound ◽  
Resonance Imaging ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Clinically Significant

Objectives: This study aimed to characterise the accuracy of multiparametric magnetic resonance imaging (mpMRI) as an adjunct to prostate biopsy, and to assess the effect of the new Australian Medicare rebate on practice at a metropolitan public hospital. Patients and methods: We identified patients who underwent transrectal ultrasound (TRUS)-guided prostate biopsy at a single institution over a two-year period. Patients were placed into two groups, depending upon whether their consent was obtained before or after the introduction of the Australian Medicare rebate for mpMRI. We extracted data on mpMRI results and TRUS-guided biopsy histopathology. Descriptive statistics were used to demonstrate baseline patient characteristics as well as MRI and histopathology results. Results: A total of 252 patients were included for analysis, of whom 128 underwent biopsy following the introduction of the Medicare rebate for mpMRI. There was a significant association between Prostate Imaging Reporting and Data System v2 (PI-RADS) classification and the diagnosis of clinically significant prostate cancer ( p<0.01). Only one man with PI-RADS ⩽2 was found to have clinically significant prostate cancer. Four men with a PI-RADS 3 lesion were found to have clinically significant cancer. A PI-RADS 4 or 5 lesion was significantly associated with the diagnosis of clinically significant cancer on multivariable analysis. Conclusion: mpMRI is an important adjunct to biopsy in the diagnosis of clinically significant prostate cancer. Our findings support the safety of omitting/delaying prostate biopsy in men with negative mpMRI. Level of evidence: Level 3 retrospective case-control study.

scholarly journals Improving Detection of Clinically Significant Prostate Cancer: Magnetic Resonance Imaging/Transrectal Ultrasound Fusion Guided Prostate Biopsy

2014 ◽  
Vol 191 (6) ◽  
pp. 1749-1754 ◽  
Author(s):  
Ardeshir R. Rastinehad ◽  
Baris Turkbey ◽  
Simpa S. Salami ◽  
Oksana Yaskiv ◽  
Arvin K. George ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Prostate Cancer ◽  
Magnetic Resonance ◽  
Prostate Biopsy ◽  
Transrectal Ultrasound ◽  
Resonance Imaging ◽  
Clinically Significant

scholarly journals Active surveillance: transperineal biopsies and evaluation of multi-parametric magnetic resonance imaging

2019 ◽  
Vol 6 (10) ◽  
pp. 3536
Author(s):  
Zubair Bhat ◽  
Arshad Bhat ◽  
Jayasimha Abbaraju ◽  
Mudassir Wani ◽  
Tahir Bhat ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Prostate Cancer ◽  
Magnetic Resonance ◽  
Active Surveillance ◽  
Prostate Biopsy ◽  
Digital Rectal Examination ◽  
Resonance Imaging ◽  
Rectal Examination ◽  
Risk Prostate Cancer ◽  
Cancer Multiple

Background: Active surveillance has emerged as an acceptable choice for low-risk prostate cancer patients and is defined as a treatment strategy of close monitoring through PSA, digital rectal examination, imaging and prostate biopsy, with conversion to curative treatment if progression occurs. An ideal tool for risk-stratification would detect aggressive cancers and exclude such men from taking up active surveillance in the first place.Methods: We retrospectively reviewed patients who underwent transperineal template biopsies from January 2016 till December 2018. All the patients had been classified as low grade prostate cancer after conventional trans-rectal ultrasound guided biopsy and enrolled in AS after discussion in hospital MDM. As per NICE guidelines all patients underwent multi-parametric magnetic resonance imaging (MRI). All suspicious lesions were assigned a PIRAD score; this was followed by Trans-perineal prostate biopsy. 142 patients were on active surveillance and underwent mapping transperineal template biopsies and cognitive target biopsies. 130 of them had multi-parametric MRI prior to the biopsies.Results: In 52% of cases the histology was upgraded. In 34 (24%) the cancer was upgraded to Gleason 3+4 and 39 (28%) it was upgraded to scores higher than Gleason 3+4. Only 64 (45%) patients continued on active surveillance post-template biopsies due to significant upgrading of histology.Conclusions: We advocate combination of MRI and an early transperineal template guided prostatic biopsies for intermediate risk prostate cancer, multiple core involvement, higher PIRAD grades and suspicious prostate on digital rectal examination in order to re-stage the initial disease and provide better safety for this cohort of patients.

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