Diagnostic Value of Cognitive-Registration Multiparametric Magnetic Resonance Guided Biopsy for the Detection of Prostate Cancer after Initial Negative Biopsy

• Published in: Acta clinica Croatica (Tisak) Vol. 57; no. Suppl 1; pp. 40 - 45
• Main Authors: Tomašković, Igor, Pezelj, Ivan, Bolanča Čulo, Karolina, Novosel, Luka, Nikles, Sven, Tomić, Miroslav, Reljić, Ante, Katušić, Josip, Knežević, Matej, Pirša, Matea, Kruslin, Božo, Ulamec, Monika, Ružić, Boris
• Format: Journal Article
• Language: English
• Published: Croatia Sestre Milosrdnice University hospital, Institute of Clinical Medical Research 01.10.2018
• Subjects: Biopsy; Humans; Image-Guided Biopsy; Magnetic Resonance Imaging; Magnetic Resonance Spectroscopy; Male; Multiparametric magnetic resonance; Prospective Studies; Prostate cancer; Prostatic Neoplasms - diagnostic imaging; Biopsy; Multiparametric magnetic resonance; Prostate cancer
• ISSN: 0353-9466; 1333-9451
• DOI: 10.20471/acc.2018.57.s1.05

The aim of this prospective clinical study was to determine the detection rate of prostate cancers by multiparametric magnetic resonance and transrectal ultrasound (mpMRI-TRUS) cognitive fusion biopsies in patients with a previously negative TRUS-guided biopsy. Between 1 October 2016 and 1 July 2017, in 101 consecutive patients with elevated antigen (PSA) and/or positive digital rectal examination and after a negative first TRUS biopsy, a second, repeated prostate biopsy was performed. In 24 patients, cognitive fusion mpMRI-TRUS biopsy of the prostate with 8-10 system cores and 1-3 target biopsies was performed, in line with the European Association of Urology guidelines. In 77 patients, only a classic, repeated TRUS guided biopsy was performed. In patients with mpMRI, the detection rate according to PIRADS-v2 reporting system was: PIRADS 1, n = 0; PIRADS 2, n = 0; PIRADS 3, n = 0; PIRADS 4, n = 6/8 (75%); and PIRADS 5, n = 2/3 (67%). In the group of patients with MR-TRUS cognitive fusion biopsy, the prostate cancer detection rate was 8/24 (33%), while in the control group the detection rate was 12/77 (16%), which was statistically significant (t test, p = 0.037, CI 95% is 0.01 to 0.37). Patients with PIRADS ≤ 3 (54%) could have avoided the biopsy.