Camille Lanz1, François Cornud2, Frédéric Beuvon3, Arnaud Lefèvre2, Paul Legmann2, Marc Zerbib1, Nicolas Barry Delongchamps4. 1. Department of Urology, Cochin Hospital, Paris Descartes University, Paris, France. 2. Department of Radiology, Cochin Hospital, Paris Descartes University, Paris, France. 3. Department of Pathology, Cochin Hospital, Paris Descartes University, Paris, France. 4. Department of Urology, Cochin Hospital, Paris Descartes University, Paris, France; Inserm U1154, Institut Necker-Enfants Malades, Paris Descartes University, Paris, France.
Abstract
PURPOSE: We evaluated the accuracy of prostate magnetic resonance imaging- transrectal ultrasound targeted biopsy for Gleason score determination. MATERIALS AND METHODS: We selected 125 consecutive patients treated with radical prostatectomy for a clinically localized prostate cancer diagnosed on magnetic resonance imaging-transrectal ultrasound targeted biopsy and/or systematic biopsy. On multiparametric magnetic resonance imaging each suspicious area was graded according to PI-RADS™ score. A correlation analysis between multiparametric magnetic resonance imaging and pathological findings was performed. Factors associated with determining the accuracy of Gleason score on targeted biopsy were statistically assessed. RESULTS: Pathological analysis of radical prostatectomy specimens detected 230 tumor foci. Multiparametric magnetic resonance imaging detected 151 suspicious areas. Of these areas targeted biopsy showed 126 cancer foci in 115 patients, and detected the index lesion in all of them. The primary Gleason grade, secondary Gleason grade and Gleason score of the 126 individual tumors were determined accurately in 114 (90%), 75 (59%) and 85 (67%) cases, respectively. Maximal Gleason score was determined accurately in 80 (70%) patients. Gleason score determination accuracy on targeted biopsy was significantly higher for low Gleason and high PI-RADS score tumors. CONCLUSIONS: Magnetic resonance imaging-transrectal ultrasound targeted biopsy allowed for an accurate estimation of Gleason score in more than two-thirds of patients. Gleason score misclassification was mostly due to a lack of accuracy in the determination of the secondary Gleason grade.
PURPOSE: We evaluated the accuracy of prostate magnetic resonance imaging- transrectal ultrasound targeted biopsy for Gleason score determination. MATERIALS AND METHODS: We selected 125 consecutive patients treated with radical prostatectomy for a clinically localized prostate cancer diagnosed on magnetic resonance imaging-transrectal ultrasound targeted biopsy and/or systematic biopsy. On multiparametric magnetic resonance imaging each suspicious area was graded according to PI-RADS™ score. A correlation analysis between multiparametric magnetic resonance imaging and pathological findings was performed. Factors associated with determining the accuracy of Gleason score on targeted biopsy were statistically assessed. RESULTS: Pathological analysis of radical prostatectomy specimens detected 230 tumor foci. Multiparametric magnetic resonance imaging detected 151 suspicious areas. Of these areas targeted biopsy showed 126 cancer foci in 115 patients, and detected the index lesion in all of them. The primary Gleason grade, secondary Gleason grade and Gleason score of the 126 individual tumors were determined accurately in 114 (90%), 75 (59%) and 85 (67%) cases, respectively. Maximal Gleason score was determined accurately in 80 (70%) patients. Gleason score determination accuracy on targeted biopsy was significantly higher for low Gleason and high PI-RADS score tumors. CONCLUSIONS: Magnetic resonance imaging-transrectal ultrasound targeted biopsy allowed for an accurate estimation of Gleason score in more than two-thirds of patients. Gleason score misclassification was mostly due to a lack of accuracy in the determination of the secondary Gleason grade.
Authors: R Diamand; M Oderda; W Al Hajj Obeid; S Albisinni; R Van Velthoven; G Fasolis; G Simone; M Ferriero; J-B Roche; T Piechaud; A Pastore; A Carbone; G Fiard; J-L Descotes; G Marra; P Gontero; E Altobelli; R Papalia; P Kumar; D Eldred-Evans; A Giacobbe; G Muto; V Lacetera; V Beatrici; T Roumeguere; A Peltier Journal: World J Urol Date: 2019-01-16 Impact factor: 4.226
Authors: Tristan Barrett; Mary McLean; Andrew N Priest; Edward M Lawrence; Andrew J Patterson; Brendan C Koo; Ilse Patterson; Anne Y Warren; Andrew Doble; Vincent J Gnanapragasam; Christof Kastner; Ferdia A Gallagher Journal: Eur Radiol Date: 2017-12-08 Impact factor: 5.315