Three-Tesla Magnetic Resonance–Guided Prostate Biopsy in Men With Increased Prostate-Specific Antigen and Repeated, Negative, Random, Systematic, Transrectal Ultrasound Biopsies: Detection of Clinically Significant Prostate Cancers
Patients with elevated prostate-specific antigen (PSA) and one or more previous negative transrectal ultrasound (TRUS) biopsy sessions are subject to diagnostic uncertainty due to TRUS-biopsy undersampling. Magnetic resonance (MR)–guided biopsy (MRGB) has shown high prostate cancer (PCa)–detection r...
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| Published in | European urology Vol. 62; no. 5; pp. 902 - 909 |
|---|---|
| Main Authors | , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Kidlington
Elsevier B.V
01.11.2012
Elsevier |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0302-2838 1873-7560 1873-7560 |
| DOI | 10.1016/j.eururo.2012.01.047 |
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| Abstract | Patients with elevated prostate-specific antigen (PSA) and one or more previous negative transrectal ultrasound (TRUS) biopsy sessions are subject to diagnostic uncertainty due to TRUS-biopsy undersampling. Magnetic resonance (MR)–guided biopsy (MRGB) has shown high prostate cancer (PCa)–detection rates in studies with limited patient numbers.
Determine the detection rate of (clinically significant) PCa for MRGB of cancer-suspicious regions (CSRs) on 3-T multiparametric MR imaging (MP-MRI) in patients with elevated PSA and one or more negative TRUS-biopsy sessions.
Of 844 patients who underwent 3-T MP-MRI in our referral centre between March 2008 and February 2011, 438 consecutive patients with a PSA >4.0 ng/ml and one negative TRUS-biopsy session or more were included. MRGB was performed in 265 patients. Exclusion criteria were existent PCa, endorectal coil use, and MP-MRI for indications other than cancer detection.
Patients underwent MRGB of MP-MRI CSRs.
(Clinically significant) MRGB cancer-detection rates were determined. Clinically significant cancer was defined by accepted (i.a. Epstein and d’Amico) criteria based on PSA, Gleason score, stage, and tumour volume. Follow-up PSA and histopathology were collected. Sensitivity analysis was performed for patients with MP-MRI CSRs without MRGB.
In a total of 117 patients, cancer was detected with MRGB (n=108) or after negative MRGB (n=9). PCa was detected in 108 of 438 patients (25%) and in 41% (108 of 265) of MRGB patients. The majority of detected cancers (87%) were clinically significant. Clinically significant cancers were detected in seven of nine (78%) negative MRGB patients in whom PCa was detected during follow-up. Sensitivity analysis resulted in increased cancer detection (47–56%). Complications occurred in 0.2% of patients (5 of 265).
In patients with elevated PSA and one or more negative TRUS-biopsy sessions, MRGB of MP-MRI CSRs had a PCa-detection rate of 41%. The majority of detected cancers were clinically significant (87%).
In patients with an elevated prostate-specific antigen level and one or more previous negative, random, systematic, transrectal ultrasound biopsy sessions, magnetic resonance (MR)–guided biopsy of detected cancer-suspicious regions on 3-T multiparametric MR imaging had a detection rate of 41% for predominantly clinically significant prostate cancers (87%). |
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| AbstractList | Abstract Background Patients with elevated prostate-specific antigen (PSA) and one or more previous negative transrectal ultrasound (TRUS) biopsy sessions are subject to diagnostic uncertainty due to TRUS-biopsy undersampling. Magnetic resonance (MR)–guided biopsy (MRGB) has shown high prostate cancer (PCa)–detection rates in studies with limited patient numbers. Objective Determine the detection rate of (clinically significant) PCa for MRGB of cancer-suspicious regions (CSRs) on 3-T multiparametric MR imaging (MP-MRI) in patients with elevated PSA and one or more negative TRUS-biopsy sessions. Design, setting, and participants Of 844 patients who underwent 3-T MP-MRI in our referral centre between March 2008 and February 2011, 438 consecutive patients with a PSA >4.0 ng/ml and one negative TRUS-biopsy session or more were included. MRGB was performed in 265 patients. Exclusion criteria were existent PCa, endorectal coil use, and MP-MRI for indications other than cancer detection. Intervention Patients underwent MRGB of MP-MRI CSRs. Measurements (Clinically significant) MRGB cancer-detection rates were determined. Clinically significant cancer was defined by accepted (i.a. Epstein and d’Amico) criteria based on PSA, Gleason score, stage, and tumour volume. Follow-up PSA and histopathology were collected. Sensitivity analysis was performed for patients with MP-MRI CSRs without MRGB. Results and limitations In a total of 117 patients, cancer was detected with MRGB ( n = 108) or after negative MRGB ( n = 9). PCa was detected in 108 of 438 patients (25%) and in 41% (108 of 265) of MRGB patients. The majority of detected cancers (87%) were clinically significant. Clinically significant cancers were detected in seven of nine (78%) negative MRGB patients in whom PCa was detected during follow-up. Sensitivity analysis resulted in increased cancer detection (47–56%). Complications occurred in 0.2% of patients (5 of 265). Conclusions In patients with elevated PSA and one or more negative TRUS-biopsy sessions, MRGB of MP-MRI CSRs had a PCa-detection rate of 41%. The majority of detected cancers were clinically significant (87%). Patients with elevated prostate-specific antigen (PSA) and one or more previous negative transrectal ultrasound (TRUS) biopsy sessions are subject to diagnostic uncertainty due to TRUS-biopsy undersampling. Magnetic resonance (MR)-guided biopsy (MRGB) has shown high prostate cancer (PCa)-detection rates in studies with limited patient numbers. Determine the detection rate of (clinically significant) PCa for MRGB of cancer-suspicious regions (CSRs) on 3-T multiparametric MR imaging (MP-MRI) in patients with elevated PSA and one or more negative TRUS-biopsy sessions. Of 844 patients who underwent 3-T MP-MRI in our referral centre between March 2008 and February 2011, 438 consecutive patients with a PSA >4.0 ng/ml and one negative TRUS-biopsy session or more were included. MRGB was performed in 265 patients. Exclusion criteria were existent PCa, endorectal coil use, and MP-MRI for indications other than cancer detection. Patients underwent MRGB of MP-MRI CSRs. (Clinically significant) MRGB cancer-detection rates were determined. Clinically significant cancer was defined by accepted (i.a. Epstein and d'Amico) criteria based on PSA, Gleason score, stage, and tumour volume. Follow-up PSA and histopathology were collected. Sensitivity analysis was performed for patients with MP-MRI CSRs without MRGB. In a total of 117 patients, cancer was detected with MRGB (n=108) or after negative MRGB (n=9). PCa was detected in 108 of 438 patients (25%) and in 41% (108 of 265) of MRGB patients. The majority of detected cancers (87%) were clinically significant. Clinically significant cancers were detected in seven of nine (78%) negative MRGB patients in whom PCa was detected during follow-up. Sensitivity analysis resulted in increased cancer detection (47-56%). Complications occurred in 0.2% of patients (5 of 265). In patients with elevated PSA and one or more negative TRUS-biopsy sessions, MRGB of MP-MRI CSRs had a PCa-detection rate of 41%. The majority of detected cancers were clinically significant (87%). Patients with elevated prostate-specific antigen (PSA) and one or more previous negative transrectal ultrasound (TRUS) biopsy sessions are subject to diagnostic uncertainty due to TRUS-biopsy undersampling. Magnetic resonance (MR)–guided biopsy (MRGB) has shown high prostate cancer (PCa)–detection rates in studies with limited patient numbers. Determine the detection rate of (clinically significant) PCa for MRGB of cancer-suspicious regions (CSRs) on 3-T multiparametric MR imaging (MP-MRI) in patients with elevated PSA and one or more negative TRUS-biopsy sessions. Of 844 patients who underwent 3-T MP-MRI in our referral centre between March 2008 and February 2011, 438 consecutive patients with a PSA >4.0 ng/ml and one negative TRUS-biopsy session or more were included. MRGB was performed in 265 patients. Exclusion criteria were existent PCa, endorectal coil use, and MP-MRI for indications other than cancer detection. Patients underwent MRGB of MP-MRI CSRs. (Clinically significant) MRGB cancer-detection rates were determined. Clinically significant cancer was defined by accepted (i.a. Epstein and d’Amico) criteria based on PSA, Gleason score, stage, and tumour volume. Follow-up PSA and histopathology were collected. Sensitivity analysis was performed for patients with MP-MRI CSRs without MRGB. In a total of 117 patients, cancer was detected with MRGB (n=108) or after negative MRGB (n=9). PCa was detected in 108 of 438 patients (25%) and in 41% (108 of 265) of MRGB patients. The majority of detected cancers (87%) were clinically significant. Clinically significant cancers were detected in seven of nine (78%) negative MRGB patients in whom PCa was detected during follow-up. Sensitivity analysis resulted in increased cancer detection (47–56%). Complications occurred in 0.2% of patients (5 of 265). In patients with elevated PSA and one or more negative TRUS-biopsy sessions, MRGB of MP-MRI CSRs had a PCa-detection rate of 41%. The majority of detected cancers were clinically significant (87%). In patients with an elevated prostate-specific antigen level and one or more previous negative, random, systematic, transrectal ultrasound biopsy sessions, magnetic resonance (MR)–guided biopsy of detected cancer-suspicious regions on 3-T multiparametric MR imaging had a detection rate of 41% for predominantly clinically significant prostate cancers (87%). Patients with elevated prostate-specific antigen (PSA) and one or more previous negative transrectal ultrasound (TRUS) biopsy sessions are subject to diagnostic uncertainty due to TRUS-biopsy undersampling. Magnetic resonance (MR)-guided biopsy (MRGB) has shown high prostate cancer (PCa)-detection rates in studies with limited patient numbers.BACKGROUNDPatients with elevated prostate-specific antigen (PSA) and one or more previous negative transrectal ultrasound (TRUS) biopsy sessions are subject to diagnostic uncertainty due to TRUS-biopsy undersampling. Magnetic resonance (MR)-guided biopsy (MRGB) has shown high prostate cancer (PCa)-detection rates in studies with limited patient numbers.Determine the detection rate of (clinically significant) PCa for MRGB of cancer-suspicious regions (CSRs) on 3-T multiparametric MR imaging (MP-MRI) in patients with elevated PSA and one or more negative TRUS-biopsy sessions.OBJECTIVEDetermine the detection rate of (clinically significant) PCa for MRGB of cancer-suspicious regions (CSRs) on 3-T multiparametric MR imaging (MP-MRI) in patients with elevated PSA and one or more negative TRUS-biopsy sessions.Of 844 patients who underwent 3-T MP-MRI in our referral centre between March 2008 and February 2011, 438 consecutive patients with a PSA >4.0 ng/ml and one negative TRUS-biopsy session or more were included. MRGB was performed in 265 patients. Exclusion criteria were existent PCa, endorectal coil use, and MP-MRI for indications other than cancer detection.DESIGN, SETTING, AND PARTICIPANTSOf 844 patients who underwent 3-T MP-MRI in our referral centre between March 2008 and February 2011, 438 consecutive patients with a PSA >4.0 ng/ml and one negative TRUS-biopsy session or more were included. MRGB was performed in 265 patients. Exclusion criteria were existent PCa, endorectal coil use, and MP-MRI for indications other than cancer detection.Patients underwent MRGB of MP-MRI CSRs.INTERVENTIONPatients underwent MRGB of MP-MRI CSRs.(Clinically significant) MRGB cancer-detection rates were determined. Clinically significant cancer was defined by accepted (i.a. Epstein and d'Amico) criteria based on PSA, Gleason score, stage, and tumour volume. Follow-up PSA and histopathology were collected. Sensitivity analysis was performed for patients with MP-MRI CSRs without MRGB.MEASUREMENTS(Clinically significant) MRGB cancer-detection rates were determined. Clinically significant cancer was defined by accepted (i.a. Epstein and d'Amico) criteria based on PSA, Gleason score, stage, and tumour volume. Follow-up PSA and histopathology were collected. Sensitivity analysis was performed for patients with MP-MRI CSRs without MRGB.In a total of 117 patients, cancer was detected with MRGB (n=108) or after negative MRGB (n=9). PCa was detected in 108 of 438 patients (25%) and in 41% (108 of 265) of MRGB patients. The majority of detected cancers (87%) were clinically significant. Clinically significant cancers were detected in seven of nine (78%) negative MRGB patients in whom PCa was detected during follow-up. Sensitivity analysis resulted in increased cancer detection (47-56%). Complications occurred in 0.2% of patients (5 of 265).RESULTS AND LIMITATIONSIn a total of 117 patients, cancer was detected with MRGB (n=108) or after negative MRGB (n=9). PCa was detected in 108 of 438 patients (25%) and in 41% (108 of 265) of MRGB patients. The majority of detected cancers (87%) were clinically significant. Clinically significant cancers were detected in seven of nine (78%) negative MRGB patients in whom PCa was detected during follow-up. Sensitivity analysis resulted in increased cancer detection (47-56%). Complications occurred in 0.2% of patients (5 of 265).In patients with elevated PSA and one or more negative TRUS-biopsy sessions, MRGB of MP-MRI CSRs had a PCa-detection rate of 41%. The majority of detected cancers were clinically significant (87%).CONCLUSIONSIn patients with elevated PSA and one or more negative TRUS-biopsy sessions, MRGB of MP-MRI CSRs had a PCa-detection rate of 41%. The majority of detected cancers were clinically significant (87%). |
| Author | Sedelaar, J.P. Michiel Barentsz, Jelle O. Vergunst, Henk Fütterer, Jurgen J. Hambrock, Thomas Hulsbergen-van de Kaa, Christina A. Schouten, Martijn G. Bomers, Joyce G.R. Hoeks, Caroline M.A. Hoogendoorn, Stefan P. |
| Author_xml | – sequence: 1 givenname: Caroline M.A. surname: Hoeks fullname: Hoeks, Caroline M.A. email: C.Hoeks@rad.umcn.nl organization: Department of Radiology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands – sequence: 2 givenname: Martijn G. surname: Schouten fullname: Schouten, Martijn G. organization: Department of Radiology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands – sequence: 3 givenname: Joyce G.R. surname: Bomers fullname: Bomers, Joyce G.R. organization: Department of Radiology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands – sequence: 4 givenname: Stefan P. surname: Hoogendoorn fullname: Hoogendoorn, Stefan P. organization: Department of Radiology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands – sequence: 5 givenname: Christina A. surname: Hulsbergen-van de Kaa fullname: Hulsbergen-van de Kaa, Christina A. organization: Department of Pathology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands – sequence: 6 givenname: Thomas surname: Hambrock fullname: Hambrock, Thomas organization: Department of Radiology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands – sequence: 7 givenname: Henk surname: Vergunst fullname: Vergunst, Henk organization: Department of Urology, Canisius Wilhelmina Hospital Nijmegen, The Netherlands – sequence: 8 givenname: J.P. Michiel surname: Sedelaar fullname: Sedelaar, J.P. Michiel organization: Department of Urology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands – sequence: 9 givenname: Jurgen J. surname: Fütterer fullname: Fütterer, Jurgen J. organization: Department of Radiology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands – sequence: 10 givenname: Jelle O. surname: Barentsz fullname: Barentsz, Jelle O. organization: Department of Radiology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands |
| BackLink | http://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=26437716$$DView record in Pascal Francis https://www.ncbi.nlm.nih.gov/pubmed/22325447$$D View this record in MEDLINE/PubMed |
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| ContentType | Journal Article |
| Copyright | 2012 European Association of Urology European Association of Urology 2015 INIST-CNRS Copyright © 2012 European Association of Urology. Published by Elsevier B.V. All rights reserved. |
| Copyright_xml | – notice: 2012 European Association of Urology – notice: European Association of Urology – notice: 2015 INIST-CNRS – notice: Copyright © 2012 European Association of Urology. Published by Elsevier B.V. All rights reserved. |
| DBID | AAYXX CITATION IQODW CGR CUY CVF ECM EIF NPM 7X8 |
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| Keywords | Magnetic resonance imaging Prostate biopsy Prostate cancer Nephrology Prostate disease Male Tumoral marker Urology Prostate specific antigen Adult Diagnosis Urogenital system Male genital diseases Ultrasound Repetition Human Urinary system disease Magnetic resonance Malignant tumor Nuclear magnetic resonance imaging Guidance Anatomic pathology Biopsy Medical imagery Prostate Cancer |
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Part 1: PSA and PSA kinetics publication-title: Eur Urol doi: 10.1016/j.eururo.2007.10.047 |
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| Snippet | Patients with elevated prostate-specific antigen (PSA) and one or more previous negative transrectal ultrasound (TRUS) biopsy sessions are subject to... Abstract Background Patients with elevated prostate-specific antigen (PSA) and one or more previous negative transrectal ultrasound (TRUS) biopsy sessions are... |
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| SubjectTerms | Aged Biological and medical sciences Chi-Square Distribution Gynecology. Andrology. Obstetrics Humans Image-Guided Biopsy - methods Kallikreins - blood Logistic Models Magnetic resonance imaging Magnetic Resonance Imaging, Interventional Male Male genital diseases Medical sciences Middle Aged Multivariate Analysis Neoplasm Grading Neoplasm Staging Nephrology. Urinary tract diseases Netherlands Predictive Value of Tests Prognosis Prostate biopsy Prostate cancer Prostate-Specific Antigen - blood Prostatic Neoplasms - blood Prostatic Neoplasms - diagnosis Prostatic Neoplasms - diagnostic imaging Prostatic Neoplasms - pathology Referral and Consultation Retrospective Studies Sensitivity and Specificity Tumor Burden Tumors Tumors of the urinary system Ultrasonography, Interventional Up-Regulation Urinary tract. Prostate gland Urology |
| Title | Three-Tesla Magnetic Resonance–Guided Prostate Biopsy in Men With Increased Prostate-Specific Antigen and Repeated, Negative, Random, Systematic, Transrectal Ultrasound Biopsies: Detection of Clinically Significant Prostate Cancers |
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