Iulia Andras1, Dana Crisan2, Emanuel Cata3, Attila Tamas-Szora4, Cosmin Caraiani5, Radu-Tudor Coman6, Catalina Bungardean7, Claudiu Mirescu8, Ioan Coman9, Nicolae Crisan10. 1. Department of Urology, Iuliu Hatieganu Unviersity of Medicine and Pharmacy, Cluj-Napoca, Romania; Department of Urology, Clinical Municipal Hospital, Cluj-Napoca, Romania. dr.iuliaandras@gmail.com. 2. Internal Medicine Department, 5th Medical Clinic, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania; Internal Medicine Department, Clinical Municipal Hospital Cluj-Napoca, Romania. crisan.dc@gmail.com. 3. Urology Department, Clinical Municipal Hospital Cluj-Napoca, Romania. emanuelcata@yahoo.com. 4. Radiology Department, Clinical Municipal Hospital Cluj-Napoca, Romania. attitamas@yahoo.com. 5. Medical Imaging Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania. ccaraiani@yahoo.com. 6. Epidemiology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania. rtcoman@yahoo.com. 7. Pathology Department, Clinical Municipal Hospital Cluj-Napoca, Romania. maria.bungardean@yahoo.com. 8. Pathology Department, Clinical Municipal Hospital Cluj-Napoca, Romania. claudiu.mirescu@gmail.com. 9. Department of Urology, Iuliu Hatieganu Unviersity of Medicine and Pharmacy, Cluj-Napoca, Romania; Department of Urology, Clinical Municipal Hospital, Cluj-Napoca, Romania. jcoman@yahoo.com. 10. Department of Urology, Iuliu Hatieganu Unviersity of Medicine and Pharmacy, Cluj-Napoca, Romania; Department of Urology, Clinical Municipal Hospital, Cluj-Napoca, Romania. drnicolaecrisan@gmail.com.
Abstract
AIMS: To present our initial experience and results of MRI-TRUS fusion guided prostate biopsy and assess the role of contralateral lobe systematic biopsy. MATERIAL AND METHOD: A number of 119 patients with clinical or biochemical suspicion for prostate cancer (PCa) were included. All patients harbored at least one PIRADS score ≥ 3 lesion and underwent MRI-TRUS fusion guided biopsy, as well as a concurrent systematic biopsy. The biopsy was performed by the same operator, using a rigidregistration software system. RESULTS: The mean age of the patients was 62.2 years. The mean pre-biopsy PSA was 9.15 ng/dl. The diagnosis rate of MRI-TRUS fusion guided biopsy was 47% for overall PCa and 29.4% for clinically significant (cs) PCa. A higher PIRADS score was significantly associated with the presence of overall and csPCa. MRI-TRUS fusion guided biopsy had a higher percentage of positive biopsy cores (51% vs 29%), higher likelihood of csPCa (OR 5.36, p=0.008) and upgrading (14.8%) in comparison with systematic biopsy but missed 6.7% csPCa. The contralateral lobe systematic biopsy could have been avoided without losing the PCa diagnosis all patients with PIRADS score 5, both in initial and repeat biopsy setting. Anterior and transitional lesions were more likely to be diagnosed only by targeted cores. CONCLUSION: MRI-TRUS guided prostate biopsy improves the detection of PCa, but systematic biopsy is still essential. In selected cases (PIRADS 5), contralateral lobe systematic biopsy can safely be avoided. Pre-biopsy mpMRI might reduce the number of biopsy sessions in patients with anterior and transitional lesions.
AIMS: To present our initial experience and results of MRI-TRUS fusion guided prostate biopsy and assess the role of contralateral lobe systematic biopsy. MATERIAL AND METHOD: A number of 119 patients with clinical or biochemical suspicion for prostate cancer (PCa) were included. All patients harbored at least one PIRADS score ≥ 3 lesion and underwent MRI-TRUS fusion guided biopsy, as well as a concurrent systematic biopsy. The biopsy was performed by the same operator, using a rigidregistration software system. RESULTS: The mean age of the patients was 62.2 years. The mean pre-biopsy PSA was 9.15 ng/dl. The diagnosis rate of MRI-TRUS fusion guided biopsy was 47% for overall PCa and 29.4% for clinically significant (cs) PCa. A higher PIRADS score was significantly associated with the presence of overall and csPCa. MRI-TRUS fusion guided biopsy had a higher percentage of positive biopsy cores (51% vs 29%), higher likelihood of csPCa (OR 5.36, p=0.008) and upgrading (14.8%) in comparison with systematic biopsy but missed 6.7% csPCa. The contralateral lobe systematic biopsy could have been avoided without losing the PCa diagnosis all patients with PIRADS score 5, both in initial and repeat biopsy setting. Anterior and transitional lesions were more likely to be diagnosed only by targeted cores. CONCLUSION: MRI-TRUS guided prostate biopsy improves the detection of PCa, but systematic biopsy is still essential. In selected cases (PIRADS 5), contralateral lobe systematic biopsy can safely be avoided. Pre-biopsy mpMRI might reduce the number of biopsy sessions in patients with anterior and transitional lesions.
Authors: Emanuel Darius Cata; Charles Van Praet; Iulia Andras; Pierre Kadula; Razvan Ognean; Maximilian Buzoianu; Daniel Leucuta; Cosmin Caraiani; Attila Tamas-Szora; Karel Decaestecker; Ioan Coman; Nicolae Crisan Journal: Transl Androl Urol Date: 2021-05
Authors: Emanuel Cata; Iulia Andras; Matteo Ferro; Pierre Kadula; Daniel Leucuta; Gennaro Musi; Deliu-Victor Matei; Ottavio De Cobelli; Attila Tamas-Szora; Cosmin Caraiani; Andrei Lebovici; Flavia Epure; Maria Bungardean; Radu-Tudor Coman; Nicolae Crisan Journal: Transl Androl Urol Date: 2020-12
Authors: Marinus J Hagens; Mar Fernandez Salamanca; Anwar R Padhani; Pim J van Leeuwen; Henk G van der Poel; Ivo G Schoots Journal: Eur Urol Open Sci Date: 2022-05-02