Diagnostic Performance of Multiparametric Magnetic Resonance Imaging and Fusion Targeted Biopsy to Detect Significant Prostate Cancer.

Multiparametric magnetic resonance imaging combined with ultrasound-fusion-targeted biopsy of the prostate intends to increase diagnostic precision, which has to be clarified.

We performed multiparametric magnetic resonance imaging followed by ultrasound-fusion-guided perineal biopsy in 99 male patients with elevated prostate-specific-antigen and previous negative standard biopsy-procedures.

In 33/99 patients (33%) no malignancy could be confirmed by histopathology. Low-grade carcinomas (Gleason-Score 6+7a) were found in 42/66 (64%) and high-grade carcinomas (Gleason-Score ≥7b) in 24/66 (36%) men. A high-grade carcinoma corresponded to PI-RADS 4 or 5 (suspected malignancy) in 21/24 cases, which accounted for a sensitivity of 88% and negative-predictive-value of 85% (p=0.002). Differentiation between high-/low-grade carcinomas (Gleason-Score ≤7a vs. ≥7b) by means of PI-RADS related to a sensitivity of 88% and a negative-predictive-value of 70% (p=0.74).

The results support the view that multiparametric magnetic resonance imaging/ultrasound-fusion-guided biopsy promotes considerably higher detection rates of clinically relevant prostate malignancies than do conventional diagnostic procedures. With regard to differentiation between high- and low-grade carcinomas, no significant difference was demonstrated.

Anticancer research. 2017 Dec [Epub]

Manuela A Hoffmann, Kasra Taymoorian, Christian Ruf, Arnd Gerhards, Karlheinz Leyendecker, Thomas Stein, Frank M Jakobs, Mathias Schreckenberger

Department of Nuclear Medicine, Johannes Gutenberg-University, Mainz, Germany ., Praxis Urologie, Koblenz, Germany., Bundeswehr Central Hospital, Department of Urology, Koblenz, Germany., Radiologisches Institut Dr. von Essen, Koblenz, Germany., Urologische Gemeinschaftspraxis, Koblenz, Germany., German Air Force Center for Aerospace Medicine, Department of Epidemiology, Fürstenfeldbruck, Germany., Department of Nuclear Medicine, Johannes Gutenberg-University, Mainz, Germany.