Prostate cancer detection rate according to lesion visibility using ultrasound and MRI.

To evaluate the difference in prostate cancer detection rates according to lesion visibility using transrectal ultrasound (TRUS) and magnetic resonance imaging (MRI) before biopsy.

Patients who underwent TRUS-guided prostate biopsy in 2016 and 2017 (n=1,022) were divided into three groups: (1) patients who did not undergo a prebiopsy MRI (group 1, n=622); (2) patients without visible lesions on the prebiopsy MRI (group 2, n=77); and (3) patients with visible lesions on the prebiopsy MRI (group 3, n=323). Biopsy results were compared using chi-square tests or independent t-tests between patients with and without TRUS-visible lesions in each group. A logistic regression test was used to determine the variables independently associated with the detection of clinically significant cancer.

Focal lesions were visible on TRUS in 710 patients. Clinically significant cancers were detected in 39.4% and 13.1% of patients with and without TRUS-visible lesions, respectively (p<0.001). The cancer detection rate was significantly higher in patients with TRUS-visible lesions in groups 1 and 3 (p<0.001). Within group 1, the Gleason scores, number of positive cores, and the cancer involvement ratios were significantly greater in patients with TRUS-visible lesions than in patients without TRUS-visible lesions. MRI- and TRUS visibility were positively associated with the detection of clinically significant prostate cancer (p=0.002 and p<0.001, respectively).

TRUS- and MRI-visible focal lesions in the prostate were significantly associated with the detection of clinically significant cancer.

Clinical radiology. 2019 Mar 04 [Epub ahead of print]

M H Choi, Y J Lee, S E Jung, J Y Lee, Y-J Choi

Department of Radiology, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; Cancer Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea., Cancer Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; Department of Urology, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. Electronic address: ., Department of Hospital Pathology, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.