Prospective Evaluation of Endorectal Magnetic Resonance Imaging to Detect Tumor Foci in Men With Prior Negative Prostastic Biopsy: A Pilot Study

Perrotti, Michael; Han, Ken-Ryu; Epstein, Robert E.; Kennedy, Eugene; Rabbani, Farhang; Badani, Ketan K.; Pantuck, Allan J.; Weiss, Robert E.; Cummings, Kenneth B.

doi:10.1016/s0022-5347(05)68275-4

Cited by 105 publications

(40 citation statements)

References 16 publications

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“…Systematic biopsies should not be performed in patients with negative results after endorectal MR imaging [38]. Perotti et al showed a high rate of tumor detection with transrectal US-guided biopsies of suspected tumor foci after the use of endorectal MR imaging findings [4]. Nevertheless, MR imaging-guided biopsy may improve accuracy because it can be performed directly, without matching MR imaging and transrectal US findings.…”

Section: Discussionmentioning

confidence: 99%

“…Likewise, magnetic resonance imaging (MRI) is an accepted and promising diagnostic option for prostate examinations. Recent studies showed that MR imaging with the use of an endorectal coil improved results in the detection of tumor foci in patients who had elevated PSA levels [4,5] and described cancer detection rates between 37 and 87% for T2-weighted endorectal MR imaging [5][6][7][8][9][10]. Particularly, the detection of lesions smaller than 5 mm in diameter is poor [11].…”

Section: Introductionmentioning

confidence: 99%

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MR-guided transgluteal biopsies with an open low-field system in patients with clinically suspected prostate cancer: technique and preliminary results

et al. 2004

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The purpose of this study was to examine the feasibility and safety of MR-guided biopsies with a transgluteal approach in patients with uncertain or suspicious prostate lesions. Twenty-five patients with uncertain or suspicious focal prostate lesions detected by high-field MR imaging of the prostate gland using endorectal coil imaging were biopsied with a transgluteal approach in a low-field MRI system (0.2 T, Concerto, Siemens). The procedures were guided using T1-weighted FLASH sequences. The prostate gland was biopsied repeatedly with a coaxial technique through a 15-gauge pencil tip with a 16-gauge biopsy handy (median 3.8 samples per patient). Complications and biopsy findings were documented retrospectively. Using T1-weighted sequences biopsy procedures were performed successfully with MR guidance in all cases without any side effects or complications. The median intervention time was 11.3 min. Pathological findings revealed ten cases of hyperplasia or atrophy, three cases of prostatitis, ten cases of carcinoma and two cases of normal tissue. The clinical follow-up showed that in two patients prostate cancer was missed at MR-guided biopsy. Transgluteal MR-guided biopsy of the prostate gland is a safe and promising approach for histological clarification of uncertain or suspicious lesions.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

MR-guided transgluteal biopsies with an open low-field system in patients with clinically suspected prostate cancer: technique and preliminary results

et al. 2004

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“…Therefore, accurate detection of SVI is vital to plan the appropriate management of patients with localized prostate cancer. MRI, with high-resolution T2-weighted scans [4], dynamic contrast enhancement [5,6], and MR spectroscopy [7][8][9], is increasingly seen as a method that can improve prostate cancer detection, characterization, staging, and treatment.…”

Section: Introductionmentioning

confidence: 99%

Seminal vesicle invasion in prostate cancer: prediction with combined T2-weighted and diffusion-weighted MR imaging

Ren

Wang

et al. 2009

Eur Radiol

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The aim of this study was to evaluate the usefulness of diffusion-weighted imaging (DWI) in detecting seminal vesicle invasion (SVI). A total of 283 patients underwent conventional MRI and DWI before prostate cancer surgery. The apparent diffusion coefficient (ADC) values of all PCa foci, SVI and seminal vesicle were measured. T2 images alone and then T2 images combined with DWI were scored for the likelihood of SVI. The area under the receiver operating characteristic curve (AUC) was used to assess accuracy. Statistical significance was inferred at P < 0.05. On pathological analysis, 39 patients had SVI. The ADC values of SVI were significantly lower than those of SV. The AUC for T2-weighted imaging plus DW imaging (0.897) was significantly larger (P < 0.05) than that for T2-weighted imaging alone (0.779). T2 images combined with DWI shows significantly higher accuracy than T2-weighted imaging alone in the detection of SVI.

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“…The sensitivity for the detection of a prostate cancer by MRT varies between 50 and 80%, depending on the study [2,[4][5][6]9]. Compared to the transrectal ultrasound (TRUS), the endorectal MRI offers a clearly higher sensitivity for the detection of a prostate tumor [2,5,[9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Prostate biopsy in the supine position in a standard 1.5-T scanner under real time MR-imaging control using a MR-compatible endorectal biopsy device

et al. 2006

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Thirty-seven consecutive patients with elevated PSA levels and negative tumor prostate biopsies underwent a MR-guided prostate biopsy in a 1.5-T scanner in the supine position. After localization of suspected tumor areas using an endorectal coil and two body-phased array coils, the biopsy device was positioned without any repositioning of the patient. The biopsy device consisted of a mount, a ball joint, a positioning stage and an insertion stage with a needle guide, which was filled with a MR-visible fluid to control positioning of the needle using a balanced steady-state free precession sequence (TrueFISP) and a high-resolution turbo spin echo (T2-TSE) sequence. Core biopsies were taken manually in the magnet. The biopsy needle could be correctly positioned in all cases. Suspected lesions with a diameter > or =10 mm could be successfully punctured. Four to nine (mean = 6) biopsies were taken per patient. In 14 patients, prostate cancer was confirmed at histology. Twenty-four biopsies positive for cancer were performed in 14 patients. A correct correlation was found between the site of biopsy and histology. MR-guided prostate biopsy can be effective in increasing primary positive tumor biopsy results in patients with a history of negative tumor TRUS-guided prostate biopsies.

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Prospective Evaluation of Endorectal Magnetic Resonance Imaging to Detect Tumor Foci in Men With Prior Negative Prostastic Biopsy: A Pilot Study

Abstract: Endorectal MRI may effectively stratify patients with prior negative prostatic biopsy into low, moderate and high risk groups for a malignant prostatic neoplasm, and may improve our ability to identify prostatic tumor foci prospectively.

Cited by 105 publications

References 16 publications

MR-guided transgluteal biopsies with an open low-field system in patients with clinically suspected prostate cancer: technique and preliminary results

MR-guided transgluteal biopsies with an open low-field system in patients with clinically suspected prostate cancer: technique and preliminary results

Seminal vesicle invasion in prostate cancer: prediction with combined T2-weighted and diffusion-weighted MR imaging

Prostate biopsy in the supine position in a standard 1.5-T scanner under real time MR-imaging control using a MR-compatible endorectal biopsy device

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