Objectives: To evaluate the correlation between multiparametric prostate magnetic resonance imaging (MP-MRI) suspicion for seminal vesicle invasion (SVI) by prostate cancer (PCa) and pathology on MRI/ultrasound (US) fusion-guided biopsy.
Patients and Methods: From March 2007 to June 2013, 822 patients underwent MP-MRI at 3 Tesla and MRI/US fusion-guided biopsy. Of these, 25 patients underwent targeted biopsy of the seminal vesicles. In 6 patients, bilateral SVI was suspected, resulting in 31 samples. MP-MRI findings that triggered these SV biopsies were scored as low, moderate, or high suspicion for SVI based on the degree of involvement on MRI. Correlative prostate biopsy and radical prostatectomy (RP) pathology were reviewed by a single genitourinary pathologist.
Results: At the time of MP-MRI, the median age was 64 years with a median prostate-specific antigen (PSA) of 10.74 ng/ml. Of the 31 SV lesions identified, MP-MRI suspicion scores of low, moderate, and high were assigned to 3, 19, and 9 lesions, respectively. MRI/US fusion-guided biopsy detected SVI in 20/31 (65%) of cases. For the 4 patients who underwent RP after a pre-operative assessment of SVI, biopsy pathology and RP pathology were concordant in all cases.
Conclusions: As this technology becomes more available, MP-MRI and MRI/US fusion-guided biopsy may play a role in the pre-operative staging for PCa. Future work will determine if improved pre-operative staging leads to better surgical outcomes.
Raskolnikov D, George AK, Rais-Bahrami S, Turkbey B, Shakir NA, Okoro C, Rothwax JT, Walton-Diaz A, Siddiqui MM, Su D, Stamatakis L, Merino MJ, Wood BJ, Choyke PL, Pinto P. Are you the author?
National Institutes of Health, Urologic Oncology Branch, National Cancer Institute, Bethesda, Maryland, United States.
Reference: J Endourol. 2014 Jul 10. Epub ahead of print.