Magnetic Resonance Imaging Guided Prostate Biopsy in Men With Repeat Negative Biopsies and Increased Prostate Specific Antigen

Hambrock, Thomas; Somford, Diederik M.; Hoeks, Caroline; Bouwense, Stefan; Huisman, Henkjan; Yakar, Derya; Oort, Inge M. van; Witjes, J. Alfred; Fütterer, Jurgen J.; Barentsz, Jelle O.

doi:10.1016/j.juro.2009.10.022

Cited by 325 publications

(232 citation statements)

References 29 publications

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“…Hence, the detection rate for clinically significant cancer in our study is 100 %. This is in accordance with and even higher than observed in the review of the literature [12,14,15,18,19,29]. This emphasizes the capability of MRGB to diagnose clinically significant cancer in patients after negative TRUS.…”

supporting

confidence: 90%

“…During MRI reading, the clinical data were available for both readers. Cancer-suspicious regions were defined using T2WI in combination with DWI, DCE-MRI, and MR spectroscopy as described by Hambrock et al [12]. A lesion was defined as suspicious in the case of: low signal intensity areas in the peripheral zone, within the transition zone, a homogeneous low T2 signal intensity area with ill-defined margins or a lenticular shape.…”

Section: Patientsmentioning

confidence: 99%

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Magnetic Resonance Imaging-Guided Prostate Biopsy: Institutional Analysis and Systematic Review

Polanec

Helbich

Margreiter

et al. 2014

Fortschr Röntgenstr

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!Objectives: To evaluate the detection rate of prostate cancer (PCa) after magnetic resonance-guided biopsy (MRGB); to monitor the patient cohort with negative MRGB results and to compare our own results with other reports in the current literature. Materials and Methods: A group of 41 patients was included in this IRB-approved study and subjected to combined MRI and MRGB. MRGB was performed in a closed 1.5 T MR unit and the needle was inserted rectally. The follow-up period ranged between 12 and 62 months (mean 3.1 years). To compare the results with the literature, a systematic literature search was performed. Eighteen publications were evaluated. Results: The cancer-suspicious regions were punctured successfully in all cases. PCa was detected in eleven patients (26.9 %) who were all clinically significant. MRGB showed a benign histology in the remaining 30 patients. In the followup (mean 3.1 years) of patients with benign histology, no new PCa was diagnosed. The missed cancer rate during follow-up was 0.0 % in our study. Conclusion: MRGB is effective for the detection of clinically significant cancer, and this is in accordance with the recent literature. In the follow-up of patients with benign histology, no new PCa was discovered. Although the probability of developing PCa after negative MRGB is very low, active surveillance is reasonable.

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supporting

confidence: 90%

Section: Patientsmentioning

confidence: 99%

Magnetic Resonance Imaging-Guided Prostate Biopsy: Institutional Analysis and Systematic Review

Polanec

Helbich

Margreiter

et al. 2014

Fortschr Röntgenstr

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“…This concept was advocated by Ahmed et al 108 Hambrock et al has shown that MRI-targeted biopsies can detect PCa in areas outside the peripheral zone or locations not biopsied in normal schemes, in particular the anterior part of the gland. 109 In that study, they utilized MRI to localize PCasuspicious areas followed by a median of four cores. They could definitely diagnose PCa in 40 out of 68 patients (59%).…”

Section: Role Of Magnetic Resonance Imaging Targeted Biopsymentioning

confidence: 99%

Prostate cancer detection after a negative prostate biopsy: Lessons learnt in the Cleveland Clinic experience

Zaytoun

Jones

2011

Int J of Urology

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Abstract:Urologists are often faced with the dilemma of managing patients with a negative initial prostate biopsy in whom clinical or pathological risk for prostate cancer still exists. Such real-life challenging scenarios might raise questions such as: Who should undergo further biopsies? What are the optimal predictors for prostate cancer on subsequent biopsies? What is the optimal biopsy protocol that should be used? When to stop the biopsy cascade? The last decade has witnessed numerous studies that have analyzed factors conferring a significant risk for cancer discovered on repeat biopsies. We and others have developed predictive models to aid decision-making regarding pursuing further biopsies. For decades, high-grade prostatic intraepithelial neoplasia has been considered a strong risk indicator for subsequent cancer. However, it has been recently shown that only through segmentation of this heterogeneous population does the real risk profile emerge. Biopsy templates underwent modification regarding the number and location of cores with emergence of the transrectal or brachytherapy grid transperineal saturation biopsy. However, the best biopsy protocol remains controversial. We have refined the initial biopsy template to a 14 core initial biopsy template that optimizes cancer detection, and have shown that transrectal saturation biopsy significantly improves cancer detection for repeat biopsy. Another concern is the overdiagnosis of clinically insignificant cancer on repeat biopsies, so we explored ways to limit this, and to deal with its ramifications. Through carrying out a Medline literature search, we critically evaluated pertinent articles together with emphasis of our own journey in this arena to assist in the decision-making process for repeat biopsy population.

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“…Development of multiparametric MRI (mpMRI) techniques has increased the detection of significant cancers and the sensitivity for the determination of its aggression [15][16][17][18][19][20][21][22]. Clinical guidelines advise performing an mpMRI when the clinical suspicion on prostate cancer persists despite prior negative TRUS biopsy results to investigate the possibility of ventrally located lesions [3,4].…”

Section: Introductionmentioning

confidence: 99%

“…Using in-bore MRI guided biopsy (MRGB) real-time MR imaging is performed to guide the biopsy procedure. A recent systematic review demonstrated increased TDR of significant prostate cancer in a large cohort using MRGB [17,22,27]. Despite these results MRGB remains controversial due to impracticalities, as its low availability, required expertise and time consuming nature.…”

Section: Introductionmentioning

confidence: 99%

Fusion Target Biopsy of the Prostate Using Real-Time Ultrasound and MR Images. A Multicenter RCT on Target Biopsy Techniques in the Diagnosis of Prostate Cancer

Wegelin¹,

Melick²

2015

J Clin Trials

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Background: The current standard technique for prostate cancer detection is trans-rectal ultrasound (TRUS) guided biopsy, and is renowned for its low sensitivity. Developments of multiparametric MRI techniques have increased the detection of significant prostate cancer. Currently there are three techniques utilizing MRI for targeted biopsy: MRI-TRUS fusion, 'cognitive' TRUS, and in-bore MRI guided biopsy. There is no consensus which should be preferred. The current study aims to compare prostate cancer detection rates of three target biopsy procedures.

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Magnetic Resonance Imaging Guided Prostate Biopsy in Men With Repeat Negative Biopsies and Increased Prostate Specific Antigen

Cited by 325 publications

References 29 publications

Magnetic Resonance Imaging-Guided Prostate Biopsy: Institutional Analysis and Systematic Review

Magnetic Resonance Imaging-Guided Prostate Biopsy: Institutional Analysis and Systematic Review

Prostate cancer detection after a negative prostate biopsy: Lessons learnt in the Cleveland Clinic experience

Fusion Target Biopsy of the Prostate Using Real-Time Ultrasound and MR Images. A Multicenter RCT on Target Biopsy Techniques in the Diagnosis of Prostate Cancer

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