Christopher P Filson1,2, Shyam Natarajan1,3, Daniel J A Margolis4, Jiaoti Huang5, Patricia Lieu1, Frederick J Dorey1, Robert E Reiter1, Leonard S Marks1. 1. Department of Urology, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California. 2. Department of Urology, Emory University, Atlanta, Georgia. 3. Center for Advanced Surgical and Interventional Technology, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California. 4. Department of Radiology, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California. 5. Department of Pathology, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California.
Abstract
BACKGROUND: The current study was conducted to evaluate the performance of magnetic resonance (MR)-ultrasound-guided fusion biopsy in diagnosing clinically significant prostate cancer (csCaP). METHODS: A total of 1042 men underwent multiparametric MR imaging (mpMRI) and fusion biopsy consecutively in a prospective trial (2009-2014). An expert reader graded mpMRI regions of interest (ROIs) as 1 to 5 using published protocols. The fusion biopsy device was used to obtain targeted cores from ROIs (when present) followed by a fusion image-guided, 12-core systematic biopsy in all men, even if no suspicious ROI was noted. The primary endpoint of the study was the detection of csCaP (ie, Gleason score ≥ 7). RESULTS: Among 825 men with ≥ 1 suspicious ROI of ≥ grade 3, 289 (35%) were found to have csCaP. Powerful predictors of csCaP were ROI grade (grade 5 vs grade 3: odds ratio, 6.5 [P<.01]) and prostate-specific antigen density (each increase of 0.05 ng/mL/cc: odds ratio, 1.4 [P<.01]). Combining systematic and targeted biopsies resulted in the detection of more patients with csCaP (289 patients) than targeting (229 patients) or systematic (199 patients) biopsy alone. Among patients with no suspicious ROI, 35 (16%) were found to have csCaP on systematic biopsy. CONCLUSIONS: In this prospective trial, MR-ultrasound fusion biopsy allowed for the detection of csCaP, with a direct relationship noted with ROI grade and prostate-specific antigen density. The combination of targeted and systematic biopsy detected more csCaP than either modality alone; systematic biopsies revealed csCaP in 16% of men with no suspicious MRI target. The advantages of this new biopsy method are apparent, but issues of cost, training, and reliability await resolution before its widespread adoption.
BACKGROUND: The current study was conducted to evaluate the performance of magnetic resonance (MR)-ultrasound-guided fusion biopsy in diagnosing clinically significant prostate cancer (csCaP). METHODS: A total of 1042 men underwent multiparametric MR imaging (mpMRI) and fusion biopsy consecutively in a prospective trial (2009-2014). An expert reader graded mpMRI regions of interest (ROIs) as 1 to 5 using published protocols. The fusion biopsy device was used to obtain targeted cores from ROIs (when present) followed by a fusion image-guided, 12-core systematic biopsy in all men, even if no suspicious ROI was noted. The primary endpoint of the study was the detection of csCaP (ie, Gleason score ≥ 7). RESULTS: Among 825 men with ≥ 1 suspicious ROI of ≥ grade 3, 289 (35%) were found to have csCaP. Powerful predictors of csCaP were ROI grade (grade 5 vs grade 3: odds ratio, 6.5 [P<.01]) and prostate-specific antigen density (each increase of 0.05 ng/mL/cc: odds ratio, 1.4 [P<.01]). Combining systematic and targeted biopsies resulted in the detection of more patients with csCaP (289 patients) than targeting (229 patients) or systematic (199 patients) biopsy alone. Among patients with no suspicious ROI, 35 (16%) were found to have csCaP on systematic biopsy. CONCLUSIONS: In this prospective trial, MR-ultrasound fusion biopsy allowed for the detection of csCaP, with a direct relationship noted with ROI grade and prostate-specific antigen density. The combination of targeted and systematic biopsy detected more csCaP than either modality alone; systematic biopsies revealed csCaP in 16% of men with no suspicious MRI target. The advantages of this new biopsy method are apparent, but issues of cost, training, and reliability await resolution before its widespread adoption.
Authors: Hamidreza Abdi; Homayoun Zargar; S Larry Goldenberg; Triona Walshe; Farshad Pourmalek; Christopher Eddy; Silvia D Chang; Martin E Gleave; Alison C Harris; Alan I So; Lindsay Machan; Peter C Black Journal: Urol Oncol Date: 2015-02-07 Impact factor: 3.498
Authors: Jesse D Le; Nelly Tan; Eugene Shkolyar; David Y Lu; Lorna Kwan; Leonard S Marks; Jiaoti Huang; Daniel J A Margolis; Steven S Raman; Robert E Reiter Journal: Eur Urol Date: 2014-09-23 Impact factor: 20.096
Authors: M Minhaj Siddiqui; Soroush Rais-Bahrami; Baris Turkbey; Arvin K George; Jason Rothwax; Nabeel Shakir; Chinonyerem Okoro; Dima Raskolnikov; Howard L Parnes; W Marston Linehan; Maria J Merino; Richard M Simon; Peter L Choyke; Bradford J Wood; Peter A Pinto Journal: JAMA Date: 2015-01-27 Impact factor: 56.272
Authors: R Itatani; T Namimoto; S Atsuji; K Katahira; S Morishita; K Kitani; Y Hamada; M Kitaoka; T Nakaura; Y Yamashita Journal: Eur J Radiol Date: 2014-07-03 Impact factor: 3.528
Authors: Jesse D Le; Samuel Stephenson; Michelle Brugger; David Y Lu; Patricia Lieu; Geoffrey A Sonn; Shyam Natarajan; Frederick J Dorey; Jiaoti Huang; Daniel J A Margolis; Robert E Reiter; Leonard S Marks Journal: J Urol Date: 2014-05-01 Impact factor: 7.450
Authors: Geoffrey A Sonn; Edward Chang; Shyam Natarajan; Daniel J Margolis; Malu Macairan; Patricia Lieu; Jiaoti Huang; Frederick J Dorey; Robert E Reiter; Leonard S Marks Journal: Eur Urol Date: 2013-03-17 Impact factor: 20.096
Authors: Jim C Hu; Edward Chang; Shyam Natarajan; Daniel J Margolis; Malu Macairan; Patricia Lieu; Jiaoti Huang; Geoffrey Sonn; Frederick J Dorey; Leonard S Marks Journal: J Urol Date: 2014-02-08 Impact factor: 7.450
Authors: Nima Nassiri; Daniel J Margolis; Shyam Natarajan; Devi S Sharma; Jiaoti Huang; Frederick J Dorey; Leonard S Marks Journal: J Urol Date: 2016-09-14 Impact factor: 7.450
Authors: T Franz; J von Hardenberg; A Blana; H Cash; D Baumunk; G Salomon; B Hadaschik; T Henkel; J Herrmann; F Kahmann; K-U Köhrmann; J Köllermann; S Kruck; U-B Liehr; S Machtens; I Peters; J P Radtke; A Roosen; H-P Schlemmer; L Sentker; J J Wendler; U Witzsch; J-U Stolzenburg; M Schostak; R Ganzer Journal: Urologe A Date: 2017-02 Impact factor: 0.639
Authors: Niklas Westhoff; Henning Haumann; Maximilian Christian Kriegmair; Jost von Hardenberg; Johannes Budjan; Stefan Porubsky; Maurice Stephan Michel; Patrick Honeck; Manuel Ritter Journal: World J Urol Date: 2018-12-17 Impact factor: 4.226
Authors: Edward Chang; Tonye A Jones; Shyam Natarajan; Devi Sharma; Demetrios Simopoulos; Daniel J Margolis; Jiaoti Huang; Frederick J Dorey; Leonard S Marks Journal: J Urol Date: 2017-07-18 Impact factor: 7.450
Authors: Pietro Pepe; Davide D'Urso; Antonio Garufi; Giandomenico Priolo; Michele Pennisi; Giorgio Russo; Maria Gabriella Sabini; Lucia Maria Valastro; Antonio Galia; Filippo Fraggetta Journal: In Vivo Date: 2017 May-Jun Impact factor: 2.155