Lessons learned during a 6-year experience with more than 1200 patients undergoing targeted prostate biopsy via MRI/US fusion are reported:
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(1) The procedure is safe and efficient, requiring some 15-20 minutes in an office setting; (2) MRI is best performed by a radiologist with specialized training, employing a trans-abdominal multi-parametric approach and preferably a 3T magnet; (3) Grade of MRI suspicion is the most powerful predictor of biopsy results, e.g., Grade 5 usually represents cancer; (4) Some potentially-important cancers (15%-30%) are MRI-invisible; (5) Targeted biopsies provide >80% concordance with whole-organ pathology. Early enthusiasm notwithstanding, cost-effectiveness is yet to be resolved, and the technologies remain in evolution.
Urology. 2015 Jul 9. pii: S0090-4295(15)00640-8. doi: 10.1016/j.urology.2015.07.001. [Epub ahead of print]
Nassiri N1, Natarajan S2, Margolis DJ3, Marks LS4.
1 Department of Urology, University of California Los Angeles, CA, USA.
2 Department of Urology, University of California Los Angeles, CA, USA; Department of Bioengineering, University of California Los Angeles, CA, USA.
3 Department of Radiology, University of California Los Angeles, CA, USA.
4 Department of Urology, University of California Los Angeles, CA, USA.