Current status of magnetic resonance imaging (<scp>MRI</scp>) and ultrasonography fusion software platforms for guidance of prostate biopsies

Logan, Jennifer; Rais‐Bahrami, Soroush; Türkbey, Barış; Gomella, Andrew A.; Amalou, Hayet; Choyke, Peter L.; Wood, Bradford J.; Pinto, Peter A.

doi:10.1111/bju.12593

Cited by 118 publications

(91 citation statements)

References 52 publications

(88 reference statements)

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“…MRI/ultrasonography-fusion or in-bore MRI prostate biopsy (PBx) can be used for targeted biopsy [3][4][5]. The Prostate Imaging Reporting and Data System (PI-RADS) classification, which was introduced in 2012, provides a framework for standardized reporting of findings in mpMRI of the prostate and has quickly gained widespread acceptance [6,7].…”

Section: Introductionmentioning

confidence: 99%

Direct comparison of multiparametric magnetic resonance imaging (MRI) results with final histopathology in patients with proven prostate cancer in MRI/ultrasonography‐fusion biopsy

et al. 2016

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ObjectiveTo compare multiparametric magnetic resonance imaging (mpMRI) of the prostate and histological findings of both targeted MRI/ultrasonography-fusion prostate biopsy (PBx) and systematic PBx with final histology of the radical prostatectomy (RP) specimen. Patients and MethodsA total of 105 patients with prostate cancer (PCa) histopathologically proven using a combination of fusion Pbx and systematic PBx, who underwent RP, were investigated. All patients had been examined using mpMRI, applying the European Society of Urogenital Radiology criteria. Histological findings from the RP specimen were compared with those from the PBx. Whole-mount RP specimen and mpMRI results were directly compared by a uro-pathologist and a uro-radiologist in step-section analysis. ResultsIn the 105 patients with histopathologically proven PCa by combination of fusion PBx and systematic PBx, the detection rate of PCa was 90% (94/105) in fusion PBx alone and 68% (72/105) in systematic PBx alone (P = 0.001). The combination PBx detected 23 (22%) Gleason score (GS) 6, 69 (66%) GS 7 and 13 (12%) GS ≥8 tumours. Fusion PBx alone detected 25 (26%) GS 6, 57 (61%) GS 7 and 12 (13%) GS ≥8 tumours. Systematic PBx alone detected 17 (24%) GS 6, 49 (68%) GS 7 and 6 (8%) GS ≥8 tumours. . The rates of concordance with regard to GS between the PBx and RP specimen were 63% (n = 65), 54% (n = 56) and 75% (n = 78) in fusion, systematic and combination PBx (fusion and systematic PBx combined), respectively. Upgrading of the GS between PBx and RP specimen occurred in 33% (n = 34), 44% (n = 46) and 18% (n = 19) in fusion, systematic and combination PBx, respectively. c-correlation for detection of any cancer was 0.76 for combination PBx, 0.68 for fusion PBx alone and 0.23 for systematic PBx alone. In all, 84% (n = 88) of index tumours were identified by mpMRI; 86% (n = 91) of index lesions on the mpMRI were proven in the RP specimen. ConclusionsFusion PBx of tumour-suspicious lesions on mpMRI was associated with a higher detection rate of more aggressive PCa and a better tumour prediction in final histopathology than systematic PBx alone; however, combination PBx had the best concordance for the prediction of GS. Furthermore, the additional findings of systematic PBx reflect the multifocality of PCa, therefore, the combination of both biopsy methods would still represent the best approach for the prediction of the final tumour grading in PCa. KeywordsMRI/ultrasound-fusion biopsy, prostate cancer, multiparametric MRI, prostatectomy specimen, systematic biopsy, direct comparison

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Section: Introductionmentioning

confidence: 99%

Direct comparison of multiparametric magnetic resonance imaging (MRI) results with final histopathology in patients with proven prostate cancer in MRI/ultrasonography‐fusion biopsy

et al. 2016

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“…Although biopsies performed under direct MRI guidance are possible, they are technically challenging, time-consuming and expensive, requiring MRI-compatible equipment that are not available in most centers [6,7]. As an appealing alternative, MRI-TRUS fusion biopsies represent a relatively low cost method allowing an accurate alignment, or ‘registration', between the MRI and TRUS findings.…”

Section: Discussionmentioning

confidence: 99%

“…With the advent of mpMRI-targeted biopsies, the cancer detection rate (CDR), usually estimated around 33% for standard ultrasound-guided extended biopsy protocols, has known a marked improvement, both in men with previous negative PBx and in naive ones [2,3,4,5]. Initial attempts to use MRI to guide biopsies involved an ‘in-bore' approach, which is probably the most accurate method, but also time-consuming, costly and hardly reproducible [6,7]. Nowadays, an appealing alternative is represented by devices that allow the fusion between mpMRI and transrectal ultrasound (TRUS) images to accurately direct the biopsy needle to a region of interest detected by mpMRI.…”

Section: Introductionmentioning

confidence: 99%

Prostate Cancer Detection Rate with Koelis Fusion Biopsies versus Cognitive Biopsies: A Comparative Study

et al. 2016

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Objective: Targeted fusion biopsies have led to an improved prostate cancer (PCa) detection rate (CDR). Our aim was to assess if device-assisted fusion biopsies are superior to cognitive ones in terms of CDR. The association between multiparametric MRI parameters and PCa was also evaluated. Methods: We retrospectively enrolled 50 patients who underwent transrectal biopsy with elastic fusion (Koelis; group KB, n = 25) or cognitive approach (group CB, n = 25). Targeted biopsies were done on targets, while a variable number of random biopsies were performed depending on the clinical case. Results: The groups did not significantly differ in terms of age, prostate-specific antigen, prostate volume and previous biopsies. Mean number of random cores was significantly inferior in KB group (8.4 vs. 12.1) and mean number of targeted biopsies was significantly higher (3.6 vs. 2.6). CDR was higher in fusion biopsies (64 vs. 40%), with the gap becoming significant when considering CDR of MRI targets only (59 vs. 27%). The difference was marked for lesions ≤10 mm, where CDR was 52% in KB against 21% in CB group. Conclusions: According to our study, elastic fusion biopsies performed with Koelis achieve an increased per-patient and per-lesion CDR as compared to cognitive biopsies, especially in the case of lesions ≤10 mm.

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“…7,8 This technique combines the best features of two modalities: the high sensitivity and specificity of MRI for PCa and the real-time features of US, enabling accurate placement of biopsy needles for tissue diagnosis. 9 Although targeted prostate biopsy has been largely used for identifying primary prostate tumors, the potential for its use as a PCa staging modality, particularly with respect to the SVs, is under active investigation.…”

Section: Introductionmentioning

confidence: 99%

Multiparametric Magnetic Resonance Imaging and Image-Guided Biopsy to Detect Seminal Vesicle Invasion by Prostate Cancer

Raskolnikov

George

Rais‐Bahrami

et al. 2014

Journal of Endourology

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Objectives: To evaluate the correlation between multiparametric prostate MRI (MP-MRI) suspicion for seminal vesicle invasion (SVI) by prostate cancer (PCa) and pathology on MRI/ultrasound (US) fusion-guided biopsy. Patients and Methods: From March 2007 to June 2013, 822 patients underwent MP-MRI at 3 Tesla and MRI/ US fusion-guided biopsy. Of these, 25 patients underwent targeted biopsy of the seminal vesicles (SVs). In six patients, bilateral SVI was suspected, resulting in 31 samples. MP-MRI findings that triggered these SV biopsies were scored as low, moderate, or high suspicion for SVI based on the degree of involvement on MRI. Correlative prostate biopsy and radical prostatectomy (RP) pathology were reviewed by a single genitourinary pathologist. Results: At the time of MP-MRI, the median age was 64 years with a median prostate-specific antigen of 10.74 ng/mL. Of the 31 SV lesions identified, MP-MRI suspicion scores of low, moderate, and high were assigned to 3, 19, and 9 lesions, respectively. MRI/US fusion-guided biopsy detected SVI in 20/31 (65%) of cases. For the four patients who underwent RP after a preoperative assessment of SVI, biopsy pathology and RP pathology were concordant in all cases. Conclusions: As this technology becomes more available, MP-MRI and MRI/US fusion-guided biopsy may play a role in the preoperative staging for PCa. Future work will determine if improved preoperative staging leads to better surgical outcomes.

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Current status of magnetic resonance imaging (MRI) and ultrasonography fusion software platforms for guidance of prostate biopsies

Cited by 118 publications

References 52 publications

Direct comparison of multiparametric magnetic resonance imaging (MRI) results with final histopathology in patients with proven prostate cancer in MRI/ultrasonography‐fusion biopsy

Direct comparison of multiparametric magnetic resonance imaging (MRI) results with final histopathology in patients with proven prostate cancer in MRI/ultrasonography‐fusion biopsy

Prostate Cancer Detection Rate with Koelis Fusion Biopsies versus Cognitive Biopsies: A Comparative Study

Multiparametric Magnetic Resonance Imaging and Image-Guided Biopsy to Detect Seminal Vesicle Invasion by Prostate Cancer

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