Enrique Gómez Gómez1, José Valero Rosa2, Julia Carrasco Valiente1, Francisco Triviño Tarradas3, Francisco Anglada Curado1, Daniel López Ruiz3, María José Requena Tapia1. 1. Urology Department, Reina Sofia University Hospital /Córdoba University, Cordoba, Spain; Radiology Department, Maimonides Institute of Biomedical Research of Cordoba (IMIBIC)/Reina Sofia University Hospital, Cordoba, Spain. 2. Urology Department, Reina Sofia University Hospital /Córdoba University, Cordoba, Spain; Radiology Department, Maimonides Institute of Biomedical Research of Cordoba (IMIBIC)/Reina Sofia University Hospital, Cordoba, Spain. Electronic address: pepoffspring@hotmail.com. 3. Radiology Department, Maimonides Institute of Biomedical Research of Cordoba (IMIBIC)/Reina Sofia University Hospital, Cordoba, Spain; Radiology Department, Reina Sofia University Hospital, Cordoba, Spain.
Abstract
OBJECTIVE: To describe the technique of transrectal biopsy with a new device that fuses multiparametric magnetic resonance (mpMRI) and ultrasound images in real time to guide target biopsies and to evaluate our initial experience. METHODS: Patients with persistent suspicion of prostate cancer despite a previous negative biopsy and who had an mpMRI before the biopsy were selected. All patients underwent target biopsy plus standard systematic biopsy. Significant prostate cancer (sig PCa) was defined according to the Epstein criteria for standard biopsy and Gleason grade of ≥7 and a positive core length of ≥5 mm for target biopsy. RESULTS: The first 40 patients were evaluated. The median age was 65 years old. In a sagittal isotropic sequence, the fusion process was started. The fusion can be improved by using different tools such as concordant points and Global Positioning System corrections tools. In the target biopsy, a median of 4 cores was taken, whereas in the standard biopsy, 12 cores were taken. Twenty-two patients were diagnosed with prostate cancer; of these patients, 17 were diagnosed with sig PCa. The fusion target biopsy diagnosed more sig PCa than the standard biopsy; however, it was not statistically significant (37.5% vs 25%, P=.08). The probability of being diagnosed with cancer increased in correlation with the Prostate Imaging Reporting and Data System score, without reaching statistical significance (k=0.45, P=.08). CONCLUSIONS: This new device is a useful tool to guide biopsy in patients with target lesions in an mpMRI to increase the detection of sig PCa. A larger cohort would be required to show significant differences.
OBJECTIVE: To describe the technique of transrectal biopsy with a new device that fuses multiparametric magnetic resonance (mpMRI) and ultrasound images in real time to guide target biopsies and to evaluate our initial experience. METHODS:Patients with persistent suspicion of prostate cancer despite a previous negative biopsy and who had an mpMRI before the biopsy were selected. All patients underwent target biopsy plus standard systematic biopsy. Significant prostate cancer (sig PCa) was defined according to the Epstein criteria for standard biopsy and Gleason grade of ≥7 and a positive core length of ≥5 mm for target biopsy. RESULTS: The first 40 patients were evaluated. The median age was 65 years old. In a sagittal isotropic sequence, the fusion process was started. The fusion can be improved by using different tools such as concordant points and Global Positioning System corrections tools. In the target biopsy, a median of 4 cores was taken, whereas in the standard biopsy, 12 cores were taken. Twenty-two patients were diagnosed with prostate cancer; of these patients, 17 were diagnosed with sig PCa. The fusion target biopsy diagnosed more sig PCa than the standard biopsy; however, it was not statistically significant (37.5% vs 25%, P=.08). The probability of being diagnosed with cancer increased in correlation with the Prostate Imaging Reporting and Data System score, without reaching statistical significance (k=0.45, P=.08). CONCLUSIONS: This new device is a useful tool to guide biopsy in patients with target lesions in an mpMRI to increase the detection of sig PCa. A larger cohort would be required to show significant differences.
Authors: Joseba Salguero; Enrique Gómez-Gómez; José Valero-Rosa; Julia Carrasco-Valiente; Juan Mesa; Cristina Martin; Juan Pablo Campos-Hernández; Juan Manuel Rubio; Daniel López; María José Requena Journal: Korean J Radiol Date: 2020-11-26 Impact factor: 3.500