Literature DB >> 25044935

A prospective comparison of MRI-US fused targeted biopsy versus systematic ultrasound-guided biopsy for detecting clinically significant prostate cancer in patients on active surveillance.

Michael R Da Rosa1, Laurent Milot, Linda Sugar, Danny Vesprini, Hans Chung, Andrew Loblaw, Gregory R Pond, Laurence Klotz, Masoom A Haider.   

Abstract

BACKGROUND: In active surveillance (AS) patients: (i) To compare the ability of a multiparametric MRI (mpMRI)-ultrasound biopsy system to detect clinically significant (CS) prostate cancer with systematic 12-core biopsy (R-TRUSBx), and (ii) To assess the predictive value of mpMRI with biopsy as the reference standard.
METHODS: Seventy-two men on AS prospectively underwent 3T mpMRI . MRI-ultrasound fusion biopsy (UroNavBx) and R-TRUSBx was performed. CS cancer was defined using two thresholds: 1) GS ≥ 7 (CS7) and 2) GS = 6 with >50% involvement (GS6). CS cancer detection rates and predictive values were determined.
RESULTS: CS7 cancers were found in 19/72 (26%), 7 (37%) identified by UroNavBx alone, 2 (11%) by R-TRUSBx alone (P = 0.182). UroNav targeted biopsy was 6.3× more likely to yield a core positive for CS7 cancer compared with R-TRUSBx (25% of 141 versus 4% of 874, P < 0.001). Upgrading of GS occurred in 15/72 patients (21%), 13 (87%) detected by UroNavBx and 10 (67%) by R-TRUSBx. The NPV of mpMRI for CS7 cancer was 100%. MRI suspicion level significantly predicted CS cancer on multivariate analysis (OR 3.6, P < 0.001).
CONCLUSION: UroNavBx detected CS cancer with far fewer cores compared with R-TRUSBx, and mpMRI had a perfect negative predictive value in this population.
© 2014 Wiley Periodicals, Inc.

Entities:  

Keywords:  MRI-ultrasound fusion biopsy; active surveillance; multiparametric MRI; prostate

Mesh:

Year:  2014        PMID: 25044935     DOI: 10.1002/jmri.24710

Source DB:  PubMed          Journal:  J Magn Reson Imaging        ISSN: 1053-1807            Impact factor:   4.813


  35 in total

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Authors:  Iqbal Sahibzada; Deepak Batura; Giles Hellawell
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Review 5.  Prostate Biopsy in Active Surveillance Protocols: Immediate Re-biopsy and Timing of Subsequent Biopsies.

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10.  Further reduction of disqualification rates by additional MRI-targeted biopsy with transperineal saturation biopsy compared with standard 12-core systematic biopsies for the selection of prostate cancer patients for active surveillance.

Authors:  J P Radtke; T H Kuru; D Bonekamp; M T Freitag; M B Wolf; C D Alt; G Hatiboglu; S Boxler; S Pahernik; W Roth; M C Roethke; H P Schlemmer; M Hohenfellner; B A Hadaschik
Journal:  Prostate Cancer Prostatic Dis       Date:  2016-05-17       Impact factor: 5.554

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