Repeat Targeted Prostate Biopsy under Guidance of Multiparametric MRI-Correlated Real-Time Contrast-Enhanced Ultrasound for Patients with Previous Negative Biopsy and Elevated Prostate-Specific Antigen: A Prospective Study.

To prospectively determine whether multi-parametric MRI (mpMRI) - contrast-enhanced ultrasound (CEUS) correlated, imaging-guided target biopsy (TB) method could improve the detection of prostate cancer in re-biopsy setting of patients with prior negative biopsy.

From 2012 to 2014, a total of 42 Korean men with a negative result from previous systematic biopsy (SB) and elevated prostate-specific antigen underwent 3T mpMRI and real-time CEUS guided TB. Target lesions were determined by fusion of mpMRI and CEUS. Subsequently, 12-core SB was performed by a different radiologist. We compared core-based cancer detection rates (CaDR) using the generalized linear mixed model (GLIMMIX) for each biopsy method.

Core-based CaDR was higher in TB (17. 92%, 38 of 212 cores) than in SB (6. 15%, 31 of 504 cores) (p < 0. 0001; GLIMMIX). In the cancer-positive TB cores, CaDR with suspicious lesions by mpMRI was higher than that by CEUS (86. 8% vs. 60. 5%, p= 0. 02; paired t-test) and concordant rate between mpMRI and CEUS was significantly different with discordant rate (48% vs. 52%, p=0. 04; McNemar's test).

The mpMRI-CEUS correlated TB technique for the repeat prostate biopsy of patients with prior negative biopsy can improve CaDR based on the number of cores taken.

PloS one. 2015 Jun 17*** epublish ***

Dong Ryul Jang, Dae Chul Jung, Young Taik Oh, Songmi Noh, Kyunghwa Han, Kiwook Kim, Koon-Ho Rha, Young Deuk Choi, Sung Joon Hong

Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Republic of Korea. , Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Republic of Korea. , Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Republic of Korea. , Department of Pathology, Cha Medical College, Gang-Nam Cha Hospital, Seoul, Republic of Korea. , Avison Biomedical Research Center; Department of Radiology; Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Republic of Korea. , Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Republic of Korea. , Department of Urology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea. , Department of Urology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea. , Department of Urology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.

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