Samuel A Gold1, Graham R Hale1, Jonathan B Bloom1, Clayton P Smith2, Kareem N Rayn1, Vladimir Valera1, Bradford J Wood3, Peter L Choyke2, Baris Turkbey2, Peter A Pinto4. 1. Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, 10 Center Dr. Building 10, Room 1-5950, Bethesda, MD, 20892, USA. 2. Molecular Imaging Program, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA. 3. Center for Interventional Oncology, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA. 4. Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, 10 Center Dr. Building 10, Room 1-5950, Bethesda, MD, 20892, USA. pintop@mail.nih.gov.
Abstract
INTRODUCTION: Multiparametric magnetic resonance imaging (mpMRI) has improved clinicians' ability to detect clinically significant prostate cancer (csPCa). Combining or fusing these images with the real-time imaging of transrectal ultrasound (TRUS) allows urologists to better sample lesions with a targeted biopsy (Tbx) leading to the detection of greater rates of csPCa and decreased rates of low-risk PCa. In this review, we evaluate the technical aspects of the mpMRI-guided Tbx procedure to identify possible sources of error and provide clinical context to a negative Tbx. METHODS: A literature search was conducted of possible reasons for false-negative TBx. This includes discussion on false-positive mpMRI findings, termed "PCa mimics," that may incorrectly suggest high likelihood of csPCa as well as errors during Tbx resulting in inexact image fusion or biopsy needle placement. RESULTS: Despite the strong negative predictive value associated with Tbx, concerns of missed disease often remain, especially with MR-visible lesions. This raises questions about what to do next after a negative Tbx result. Potential sources of error can arise from each step in the targeted biopsy process ranging from "PCa mimics" or technical errors during mpMRI acquisition to failure to properly register MRI and TRUS images on a fusion biopsy platform to technical or anatomic limits on needle placement accuracy. CONCLUSIONS: A better understanding of these potential pitfalls in the mpMRI-guided Tbx procedure will aid interpretation of a negative Tbx, identify areas for improving technical proficiency, and improve both physician understanding of negative Tbx and patient-management options.
INTRODUCTION: Multiparametric magnetic resonance imaging (mpMRI) has improved clinicians' ability to detect clinically significant prostate cancer (csPCa). Combining or fusing these images with the real-time imaging of transrectal ultrasound (TRUS) allows urologists to better sample lesions with a targeted biopsy (Tbx) leading to the detection of greater rates of csPCa and decreased rates of low-risk PCa. In this review, we evaluate the technical aspects of the mpMRI-guided Tbx procedure to identify possible sources of error and provide clinical context to a negative Tbx. METHODS: A literature search was conducted of possible reasons for false-negative TBx. This includes discussion on false-positive mpMRI findings, termed "PCa mimics," that may incorrectly suggest high likelihood of csPCa as well as errors during Tbx resulting in inexact image fusion or biopsy needle placement. RESULTS: Despite the strong negative predictive value associated with Tbx, concerns of missed disease often remain, especially with MR-visible lesions. This raises questions about what to do next after a negative Tbx result. Potential sources of error can arise from each step in the targeted biopsy process ranging from "PCa mimics" or technical errors during mpMRI acquisition to failure to properly register MRI and TRUS images on a fusion biopsy platform to technical or anatomic limits on needle placement accuracy. CONCLUSIONS: A better understanding of these potential pitfalls in the mpMRI-guided Tbx procedure will aid interpretation of a negative Tbx, identify areas for improving technical proficiency, and improve both physician understanding of negative Tbx and patient-management options.
Authors: Yujun Guo; Priya N Werahera; Ramkrishnan Narayanan; Lu Li; Dinesh Kumar; E David Crawford; Jasjit S Suri Journal: J Ultrasound Med Date: 2009-11 Impact factor: 2.153
Authors: Vincenzo Scattoni; Carmen Maccagnano; Umberto Capitanio; Andrea Gallina; Alberto Briganti; Francesco Montorsi Journal: World J Urol Date: 2014-06-08 Impact factor: 4.226
Authors: James S Wysock; Andrew B Rosenkrantz; William C Huang; Michael D Stifelman; Herbert Lepor; Fang-Ming Deng; Jonathan Melamed; Samir S Taneja Journal: Eur Urol Date: 2013-11-08 Impact factor: 20.096
Authors: Jonathan B Bloom; Graham R Hale; Samuel A Gold; Kareem N Rayn; Clayton Smith; Sherif Mehralivand; Marcin Czarniecki; Vladimir Valera; Bradford J Wood; Maria J Merino; Peter L Choyke; Howard L Parnes; Baris Turkbey; Peter A Pinto Journal: J Urol Date: 2019-01 Impact factor: 7.450
Authors: Frank-Jan H Drost; Daniël F Osses; Daan Nieboer; Ewout W Steyerberg; Chris H Bangma; Monique J Roobol; Ivo G Schoots Journal: Cochrane Database Syst Rev Date: 2019-04-25
Authors: Luke P O'Connor; Alex Z Wang; Nitin K Yerram; Amir H Lebastchi; Michael Ahdoot; Sandeep Gurram; Johnathan Zeng; Sherif Mehralivand; Stephanie Harmon; Maria J Merino; Howard L Parnes; Peter L Choyke; Baris Turkbey; Bradford J Wood; Peter A Pinto Journal: Urology Date: 2020-07-15 Impact factor: 2.649
Authors: Cheyenne Williams; Michael Ahdoot; Michael A Daneshvar; Christian Hague; Andrew R Wilbur; Patrick T Gomella; Joanna Shih; Nabila Khondakar; Nitin Yerram; Sherif Mehralivand; Sandeep Gurram; Minhaj Siddiqui; Paul Pinsky; Howard Parnes; Maria Merino; Bradford Wood; Baris Turkbey; Peter A Pinto Journal: J Urol Date: 2021-08-26 Impact factor: 7.450
Authors: David E Korenchan; Robert Bok; Renuka Sriram; Kristina Liu; Romelyn Delos Santos; Hecong Qin; Iryna Lobach; Natalie Korn; David M Wilson; John Kurhanewicz; Robert R Flavell Journal: Oncotarget Date: 2019-10-22