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

Abstract

!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.

Evidence-based guideline recommendations on multiparametric magnetic resonance imaging in the diagnosis of prostate cancer: A Cancer Care Ontario clinical practice guideline

“…A total of 12 systematic reviews [11][12][13][14][15][16][17][18][19][20][21][22] were relevant and met the preplanned inclusion criteria; however, none of them covered both of the guideline objectives or used the same study selection criteria as ours. A total of 8663 original studies in English were identified and 15 were analyzed.…”

Multiparametric MRI of the prostate at 3 T: limited value of 3D 1H-MR spectroscopy as a fourth parameter

“…Histopathology specimens were obtained by either transrectal ultrasound or MR-guided biopsy [14]. If radical prostatectomy was performed (13/64 patients), wholemount step section was used as the reference standard.…”

Multiparametric Magnetic Resonance Imaging/Transrectal Ultrasound Fusion Targeted Biopsy of the Prostate: Preliminary Results of a Prospective Single-Centre Study

“…This method shows a very high accuracy, but it also has certain restrictions in relation to clinical routines such as the discomfort of the patient position and the long duration [6]. The second approach uses cognitive fusion whereby the clinician assigns each suspicious lesion on mpMRI findings to a predefined region of the prostate and aims to hit that specific region using transrectal ultrasound (TRUS) guidance [7].…”