MRI-guided prostate biopsy detects clinically significant cancer: analysis of a cohort of 100 patients after previous negative TRUS biopsy

Roethke, Matthias; Anastasiadis, Aristotelis G.; Lichy, Matthias P.; Werner, Matthias; Wagner, Philipp; Kruck, Stephan; Claussen, Claus D.; Stenzl, Arnulf; Schlemmer, Heinz–Peter; Schilling, David

doi:10.1007/s00345-011-0675-2

Cited by 166 publications

(92 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.…”

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confidence: 90%

“…This is slightly lower compared to other MRGB studies reporting a diagnostic accuracy ranging between 38 -59 % [5, 7 -11, 13 -16, 18, 19, 26 -30]. This could have been due to the fact that we included consecutive patients in our study and not solely patients with a high risk profile for PCa [18]. In our study patients with a low risk profile for PCa had solely a suspicious finding on diagnostic MRI and low PSA and the majority had no or just one TRUS.…”

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confidence: 60%

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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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confidence: 90%

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confidence: 60%

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

Polanec

Helbich

Margreiter

et al. 2014

Fortschr Röntgenstr

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“…Another out-of-bore approach uses the MR imaging in a cognitive manner, with the operator interpreting the previously acquired MR imaging information either as reported or by direct visualization and then performing a transrectal US sampling directed to the cognitively recalled locations (28). The transrectal MR imaging-guided biopsy studies (32)(33)(34)(35)(36)(37)(38)(39)(40) report cancer positivity rates of 8%-59%. Puech et al (41) compared cognitive and fusion techniques, showing no significant differences in biopsy yield.…”

Section: Discussionmentioning

confidence: 99%

Transperineal In-Bore 3-T MR Imaging–guided Prostate Biopsy: A Prospective Clinical Observational Study

Penzkofer¹,

Tuncalı²,

Fedorov³

et al. 2015

Radiology

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The contents of this manuscript are solely the responsibility of the authors and do not necessarily represent the official views of the National Institutes of Health.q RSNA, 2014 Purpose:To determine the detection rate, clinical relevance, Gleason grade, and location of prostate cancer (PCa) diagnosed with and the safety of an in-bore transperineal 3-T magnetic resonance (MR) imaging-guided prostate biopsy in a clinically heterogeneous patient population. Materials and Methods:This prospective retrospectively analyzed study was HIPAA compliant and institutional review board approved, and informed consent was obtained. Eighty-seven men (mean age, 66.2 years 6 6.9) underwent multiparametric endorectal prostate MR imaging at 3 T and transperineal MR imaging-guided biopsy. Three subgroups of patients with at least one lesion suspicious for cancer were included: men with no prior PCa diagnosis, men with PCa who were undergoing active surveillance, and men with treated PCa and suspected recurrence. Exclusion criteria were prior prostatectomy and/or contraindication to 3-T MR imaging. The transperineal MR imaging-guided biopsy was performed in a 70-cm wide-bore 3-T device. Overall patient biopsy outcomes, cancer detection rates, Gleason grade, and location for each subgroup were evaluated and statistically compared by using x 2 and one-way analysis of variance followed by Tukey honestly significant difference post hoc comparisons. Results:Ninety biopsy procedures were performed with no serious adverse events, with a mean of 3.7 targets sampled per gland. Cancer was detected in 51 (56.7%) men: 48.1% (25 of 52) with no prior PCa, 61.5% (eight of 13) under active surveillance, and 72.0% (18 of 25) in whom recurrence was suspected. Gleason pattern 4 or higher was diagnosed in 78.1% (25 of 32) in the no prior PCa and active surveillance groups. Gleason scores were not assigned in the suspected recurrence group. MR targets located in the anterior prostate had the highest cancer yield (40 of 64, 62.5%) compared with those for the other parts of the prostate (P , .001). Conclusion:In-bore 3-T transperineal MR imaging-guided biopsy, with a mean of 3.7 targets per gland, allowed detection of many clinically relevant cancers, many of which were located anteriorly.q RSNA, 2014

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“…MRI-guided biopsy can be utilized as a primary or secondary rebiopsy technique because the available data imply that there are higher detection rates from one MRI-guided biopsy compared to TRUS-guided repeat biopsies, up to the third rebiopsy (4). Only four 1.5 T MRI-guided biopsy studies, with a total of 176 patients, have been previously published (19,28,30,31). The reported overall detection rates ranged between 42% and 55% with a high proportion of transition zone cancers, accounting for 35% of removed cores.…”

Section: Discussionmentioning

confidence: 99%

MR-guided biopsy of the prostate: correlation of cancer detection rate with number of previous negative TRUS biopsies

Durmus¹,

Reichelt²,

Huppertz³

et al. 2013

Diagn Interv Radiol

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ORIGINAL ARTICLE PURPOSE We aimed to investigate prostate cancer detection rate of magnetic resonance imaging (MRI)-guided biopsy and to elucidate possible relations to the number of prior negative transrectal ultrasonography (TRUS)-guided biopsies. MATERIALS AND METHODSEighty-seven consecutive patients (mean age, 65.0 years; mean prostate-specific antigen, 13.3 ng/mL) with at least one prior negative TRUS-guided biopsy and persistent suspicion of prostate cancer were included in this study. All patients underwent MRI-guided biopsy after a diagnostic multiparametric MRI examination at 1.5 Tesla. Specimens were immediately fixated and subsequently evaluated by an experienced uropathologist. Prostate cancer detection rates were calculated. Prostate cancer-positive and -negative cores were compared. Correlation between number of prior biopsies and presence of prostate cancer was evaluated. RESULTSCancer detection rates for patients with one (n=24), two (n=25), three (n=18), and four or more (n=20) negative TRUS-guided biopsies were 29.2%, 40.0%, 66.7%, and 35.0%, respectively (P = 0.087). The median number of removed cores per patient was 3 (range, 1-8) without a significant difference between patients with and without cancer (P = 0.48). Thirty of 36 cancer patients were at intermediate or high risk according to the D´Amico clinical risk score. Eleven of 15 high risk cancers were localized in the transition zone (P = 0.002). CONCLUSIONSThis study demonstrates high cancer detection rates of MRI-guided biopsy independent of the number of previous TRUS-guided biopsies and the number of taken prostate cores. MRI-guided biopsy therefore represents a less invasive and effective diagnostic tool for patients with prostate cancer suspicion and previous negative TRUS-guided biopsies.

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MRI-guided prostate biopsy detects clinically significant cancer: analysis of a cohort of 100 patients after previous negative TRUS biopsy

Abstract: MR-GB shows a high detection rate of clinically significant PCa in patients with previous negative TRUS-GB and persisting suspicion for PCa.

Cited by 166 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

Transperineal In-Bore 3-T MR Imaging–guided Prostate Biopsy: A Prospective Clinical Observational Study

MR-guided biopsy of the prostate: correlation of cancer detection rate with number of previous negative TRUS biopsies

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