Comparison of re-biopsy with preceded MRI and re-biopsy without preceded MRI in patients with previous negative biopsy and persistently high PSA - Abstract

PURPOSE: To retrospectively compare re-biopsy with preceded magnetic resonance imaging (MRI) and re-biopsy without preceded MRI.

MATERIALS AND METHODS: Between January 2007 and May 2011, 669 patients (mean 64 years; range 38-91 years) underwent a re-biopsy because of previous negative biopsy (median 1; 1-5) and persistently high prostate-specific antigen (PSA 10.6 ng/ml; 2.5-997.1 ng/ml). 3T MRI using a phased-array coil was performed in 171 (MRI group) but not in 498 (non-MRI group) prior to re-biopsy. Transrectal ultrasound-guided biopsy was performed in both MRI and non-MRI groups. MRI and non-MRI groups were compared in terms of cancer detection rate ((number of cancer-proven patients/number of patients in MRI or non-MRI group) × 100) and positive core rate ((number of cancer-positive cores/number of cores in MRI or non-MRI group) × 100) using Fisher exact test. Odds ratio and 95% confidence interval were also obtained. Pathologic diagnosis of the biopsy was considered standard reference.

RESULTS: Of 669 patients, 129 (19.3%) were diagnosed with adenocarcinoma. The cancer detection rates of MRI and non-MRI groups were 33.3% (57/171) and 14.5% (72/498), respectively (p < 0.001). The positive core rates of these groups were 9.2% (167/1 818) and 3.2% (179/5 631), respectively (p < 0.001). The odd ratios of cancer detection rate and positive core rate were 3.0 (95% confidence interval 2.0-4.4) and 3.1 (2.5-3.8), respectively.

CONCLUSION: Re-biopsy with preceded MRI yields higher cancer detection rate and positive core rate than re-biopsy without preceded MRI. MRI should be considered prior to re-biopsy in patients with previous negative biopsy and persistently high PSA.

Written by:
Park BK, Jeon SS, Park B, Park JJ, Kim CK, Lee HM, Choi HY.   Are you the author?
The Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Reference: Abdom Imaging. 2014 Nov 4. Epub ahead of print.
doi: 10.1007/s00261-014-0245-3

PubMed Abstract
PMID: 25367810 Prostate Cancer Section


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