Early Second Round Targeted Biopsy of PI-RADS Score 3 or 4 in 256 Men With Persistent Suspicion of Prostate Cancer.

The aim of the study was to determine the rate of clinically significant prostate cancer (csPCa) cases in men submitted to early second round mpMRI/TRUS (multiparametric magnetic resonance imaging/transrectal ultrasound) fusion biopsy (TPBx).

From January 2016 to December 2018, 256 men with a PI-RADS (Prostate Imaging-Reporting and Data System) score 3 (80 cases) or 4 (176 cases) and negative repeat transperineal saturation biopsy plus TPBx, underwent a new TPBx (four cores) for the persistent clinical suspicion of cancer. The accuracy of mpMRI ADC (apparent diffusion coefficient) values in the diagnosis of csPCa were evaluated.

Overall detection rate of csPCa was equal to 10.1% (26/256 cases): 2.5% (2/80) versus 13.6% (24/176) had a PI-RADS score equal to 3 versus 4, respectively. The presence of csPCa was significantly correlated with an ADC value of 0.747×10-3 mm2/sec.

A negative TBPx missed a csPCa in 13.6% of PI-RADS score 4 that was diagnosed by an early second round TBPx; the evaluation of ADC maps could select mpMRI lesions deserving a repeat TPBx.

In vivo (Athens, Greece). 0000 Jan [Epub]

Pietro Pepe, Antonio Garufi, Gian Domenico Priolo, Michele Pennisi, Filippo Fraggetta

Urology Unit, Cannizzaro Hospital, Catania, Italy ., Imaging Department, Cannizzaro Hospital, Catania, Italy., Urology Unit, Cannizzaro Hospital, Catania, Italy., Pathology Unit, Cannizzaro Hospital, Catania, Italy.