Precision of MRI/ultrasound-fusion biopsy in prostate cancer diagnosis: an ex vivo comparison of alternative biopsy techniques on prostate phantoms

Westhoff, Niklas; Siegel, Fabian; Hausmann, Daniel; Poledník, Martin; Hardenberg, Jost von; Michel, Maurice Stephan; Ritter, Manuel

doi:10.1007/s00345-016-1967-3

Cited by 34 publications

(25 citation statements)

References 27 publications

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“…29 Westhoff et al reported that patients with large PV might benefit from elastic fusion biopsy, so the elastic fusion technique might detect more CSPC in patients with a PV >40 mL. 30 In conclusion, the CSPC detection rate of transperineal MRI/US rigid fusion TB was very low in patients with PI-RADS category 3. Therefore, immediately carrying out TB is probably unnecessary for these patients.…”

Section: Discussionmentioning

confidence: 80%

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Detection rate of clinically significant prostate cancer in magnetic resonance imaging and ultrasonography‐fusion transperineal targeted biopsy for lesions with a prostate imaging reporting and data system version 2 score of 3–5

et al. 2018

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Objectives To evaluate the detection rates of clinically significant prostate cancer classified according to the prostate imaging reporting and data system scoring system using magnetic resonance imaging/ultrasound rigid fusion targeted biopsy. Methods A total of 339 patients underwent transperineal magnetic resonance imaging/ultrasound rigid fusion targeted biopsy in our institution between January 2015 and July 2017. Patients with prostate imaging reporting and data system category 1 or 2 and those with a pre‐biopsy prostate‐specific antigen value of >30 ng/mL were excluded from this study. Finally, 310 patients were recruited. Results The detection rates of clinically significant prostate cancer with prostate imaging reporting and data system category 3, 4, and 5 were 1.0% (1/98), 35.1% (47/134) and 73.1% (57/78), respectively. The factors affecting the detection of clinically significant prostate cancer with prostate imaging reporting and data system categories 4 and 5 were: (i) prostate imaging reporting and data system category 5; (ii) prostate volume <40 cc; (iii) no previous biopsy; (iv) lesion located in the peripheral zone; and (v) prostate‐specific antigen density >0.35 ng/mL/mL. Conclusions The detection rate of clinically significant prostate cancer on magnetic resonance imaging/ultrasound rigid fusion targeted biopsy is very low in patients with prostate imaging reporting and data system category 3; therefore, patients with this classification should not undergo targeted biopsy. Prostate‐specific antigen density, prostate volume, locations of suspected cancer and history of biopsy should be considered to predict the detection rate of clinically significant prostate cancer with prostate imaging reporting and data system categories 4 and 5.

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Section: Discussionmentioning

confidence: 80%

“…Westhoff et al . reported that patients with large PV might benefit from elastic fusion biopsy, so the elastic fusion technique might detect more CSPC in patients with a PV >40 mL …”

Section: Discussionmentioning

confidence: 99%

Detection rate of clinically significant prostate cancer in magnetic resonance imaging and ultrasonography‐fusion transperineal targeted biopsy for lesions with a prostate imaging reporting and data system version 2 score of 3–5

et al. 2018

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“…The dimension of the lesion is important due to the inherent needle placement error, which is the lowest in MRI in-bore biopsy (2.5 mm [30] vs 3.5mm for MRI-TRUS fusion with elastic registration [31]). Rigid registration might increase the needle placement error during MRI-TRUS fusion biopsy, thus lesions with a radius smaller than 5 mm would be better targeted by in-bore biopsy.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, Westhoff et al [31] showed that although elastic image registration ensures a more precise targeting in comparison with rigid registration during MRI-TRUS fusion biopsy, it still has a low accuracy for the diagnosis of lesions located at the base (vs transitional and anterior zones) and for small volume prostates (below 50 ml).…”

Section: Discussionmentioning

confidence: 99%

MRI-TRUS fusion guided prostate biopsy – initial experience and assessment of the role of contralateral lobe systematic biopsy

Andraș

Crişan

Căta³

et al. 2019

Med Ultrason

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Aims: To present our initial experience and results of MRI-TRUS fusion guided prostate biopsy and assess the role of contralateral lobe systematic biopsy.Material and method: A number of 119 patients with clinical or biochemical suspicion for prostate cancer (PCa) were included. All patients harbored at least one PIRADS score ≥ 3 lesion and underwent MRI-TRUS fusion guided biopsy, as well as a concurrent systematic biopsy. The biopsy was performed by the same operator, using a rigidregistration software system.Results: The mean age of the patients was 62.2 years. The mean pre-biopsy PSA was 9.15 ng/dl. The diagnosis rate of MRI-TRUS fusion guided biopsy was 47% for overall PCa and 29.4% for clinically significant (cs) PCa. A higher PIRADS score was significantly associated with the presence of overall and csPCa. MRI-TRUS fusion guided biopsy had a higher percentage of positive biopsy cores (51% vs 29%), higher likelihood of csPCa (OR 5.36, p=0.008) and upgrading (14.8%) in comparison with systematic biopsy but missed 6.7% csPCa. The contralateral lobe systematic biopsy could have been avoided without losing the PCa diagnosis all patients with PIRADS score 5, both in initial and repeat biopsy setting. Anterior and transitional lesions were more likely to be diagnosed only by targeted cores.Conclusion: MRI-TRUS guided prostate biopsy improves the detection of PCa, but systematic biopsy is still essential. In selected cases (PIRADS 5), contralateral lobe systematic biopsy can safely be avoided. Pre-biopsy mpMRI might reduce the number of biopsy sessions in patients with anterior and transitional lesions.

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“…For performing the fusion between the two volumes, elastic systems take into consideration prostate movements and deformation during the insertion of the US probe, whereas rigid systems relay only on internal anatomical markers [49]. Delongchamps et al [50] showed that elastic image fusion was more accurate for cancer detection than rigid image fusion, which performed similarly with cognitive guided biopsy [51].…”

Section: Ultrasound-mri-guided Prostate Biopsymentioning

confidence: 99%

Prostate ultrasound: back in business!

et al. 2017

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The use of grey scale prostate ultrasound decreased after the implementation of magnetic resonance imaging (MRI) for the diagnosis and evaluation of prostate cancer. The new developments, such as multiparametric ultrasound and MRI-ultrasound fusion technology, renewed the interest for this imaging method in the assessment of prostate cancer. The purpose of this paper was to review the current role of prostate ultrasound in the setting of these new applications. A thorough reevaluation of the selection criteria of the patients is required to assess which patients would benefit from multiparametric ultrasound, who wouldbenefit from multiparametric MRI or the combination of both to assist prostate biopsy in order to ensure the balance between overdiagnosis and underdiagnosis of prostate cancer.

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Precision of MRI/ultrasound-fusion biopsy in prostate cancer diagnosis: an ex vivo comparison of alternative biopsy techniques on prostate phantoms

Abstract: All biopsy techniques allow detection of clinically significant tumors with a median error of 2-3 mm. Elastic image fusion appears to be the most precise technique, independent of prostate volume, target size or location.

Cited by 34 publications

References 27 publications

Detection rate of clinically significant prostate cancer in magnetic resonance imaging and ultrasonography‐fusion transperineal targeted biopsy for lesions with a prostate imaging reporting and data system version 2 score of 3–5

Detection rate of clinically significant prostate cancer in magnetic resonance imaging and ultrasonography‐fusion transperineal targeted biopsy for lesions with a prostate imaging reporting and data system version 2 score of 3–5

MRI-TRUS fusion guided prostate biopsy – initial experience and assessment of the role of contralateral lobe systematic biopsy

Prostate ultrasound: back in business!

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