Concordance between biparametric MRI, transperineal targeted plus systematic MRI-ultrasound fusion prostate biopsy, and radical prostatectomy pathology

• Published in: Scientific reports Vol. 12; no. 1; p. 6964
• Main Authors: Noh, Tae Il, Shim, Ji Sung, Kang, Sung Gu, Cheon, Jun, Lee, Jeong Gu, Lee, Jeong Hyeon, Kang, Seok Ho
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 28.04.2022; Nature Publishing Group; Nature Portfolio
• Subjects: 631/67; 631/67/589/466; Biopsy; Cancer surgery; Humanities and Social Sciences; Humans; Image processing; Image-Guided Biopsy - methods; Lesions; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; Male; multidisciplinary; Patients; Prostate - diagnostic imaging; Prostate - pathology; Prostate - surgery; Prostate cancer; Prostate-Specific Antigen; Prostatectomy; Prostatic Neoplasms - diagnostic imaging; Prostatic Neoplasms - pathology; Prostatic Neoplasms - surgery; Reproducibility of Results; Retrospective Studies; Robotic surgery; Science; Science (multidisciplinary); Ultrasonic imaging; Ultrasound; Urological surgery; United States > US
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-022-10672-4

We aimed to confirm the reliability of the results of bi-parametric magnetic resolution imaging-ultrasound fusion targeted and systematic biopsies (bpMRI-US transperineal FTSB) compared to prostatectomy specimens. We retrospectively analyzed the records of 80 men who underwent bpMRI-US transperineal FTSB with region of interest (ROI) and subsequent robot-assisted radical prostatectomy. Changes in the grade group determined by MRI and biopsy versus surgical specimens were analyzed. Thirty-five patients with insignificant prostate cancer and 45 with significant cancer were diagnosed using bpMRI-US transperineal FTSB. Among those with insignificant PCa, 25 (71.4%) were upgraded to significant PCa in prostatectomy specimens: 9/12 (75.0%) with Prostate Imaging Reporting and Data System (PI-RADS) 3, 12/16 (75.0%) with PI-RADS 4, and 4/7 (57.1%) with PI-RADS 5. In the PI-RADS 3 group, the upgraded group showed higher prostate specific antigen (PSA) and PSA density (PSAD) than the concordance group; PSA 8.34(2.73) vs. 5.31(2.46) ( p  = 0.035) and PSAD 0.29(0.11) vs. 0.18(0.09) ( p  = 0.025). The results of prostate biopsy and prostatectomy specimens were inconsistent and underestimated in patients with MRI-visible lesions. Therefore, for precise and individualized treatment strategies for PCa with MRI-visible lesions, careful interpretation of biopsy result is required.