Relationship Between Prebiopsy Multiparametric Magnetic Resonance Imaging (MRI), Biopsy Indication, and MRI-ultrasound Fusion-targeted Prostate Biopsy Outcomes.

Increasing evidence supports the use of magnetic resonance imaging (MRI)-ultrasound fusion-targeted prostate biopsy (MRF-TB) to improve the detection of clinically significant prostate cancer (PCa) while limiting detection of indolent disease compared to systematic 12-core biopsy (SB).

To compare MRF-TB and SB results and investigate the relationship between biopsy outcomes and prebiopsy MRI.

Retrospective analysis of a prospectively acquired cohort of men presenting for prostate biopsy over a 26-mo period. A total of 601 of 803 consecutively eligible men were included.

All men were offered prebiopsy MRI and assigned a maximum MRI suspicion score (mSS). Men with an MRI abnormality underwent combined MRF-TB and SB.

Detection rates for all PCa and high-grade PCa (Gleason score [GS] ≥7) were compared using the McNemar test.

MRF-TB detected fewer GS 6 PCas (75 vs 121; p

MRF-TB detects more high-grade PCas than SB while limiting detection of GS 6 PCa in men presenting for prostate biopsy. These findings suggest that prebiopsy multiparametric MRI and MRF-TB should be considered for all men undergoing prostate biopsy. In addition, mSS in conjunction with biopsy indications may ultimately help in identifying men at low risk of high-grade cancer for whom prostate biopsy may not be warranted.

We examined how magnetic resonance imaging (MRI)-targeted prostate biopsy compares to traditional systematic biopsy in detecting prostate cancer among men with suspicion of prostate cancer. We found that MRI-targeted biopsy detected more high-grade cancers than systematic biopsy, and that MRI performed before biopsy can predict the risk of high-grade cancer.

European urology. 2015 Jun 22 [Epub ahead of print]

Xiaosong Meng, Andrew B Rosenkrantz, Neil Mendhiratta, Michael Fenstermaker, Richard Huang, James S Wysock, Marc A Bjurlin, Susan Marshall, Fang-Ming Deng, Ming Zhou, Jonathan Melamed, William C Huang, Herbert Lepor, Samir S Taneja

Department of Urology, NYU Langone Medical Center, New York, NY, USA. , Department of Radiology, NYU Langone Medical Center, New York, NY, USA. , School of Medicine, NYU Langone Medical Center, New York, NY, USA. , School of Medicine, NYU Langone Medical Center, New York, NY, USA. , Department of Urology, NYU Langone Medical Center, New York, NY, USA. , Department of Urology, NYU Langone Medical Center, New York, NY, USA; Department of Urology, New York Hospital Queens, Flushing, NY, USA. , Department of Urology, NYU Langone Medical Center, New York, NY, USA; Department of Urology, St. Barnabas Hospital, Bronx, NY, USA. , Department of Urology, NYU Langone Medical Center, New York, NY, USA. , Department of Pathology, NYU Langone Medical Center, New York, NY, USA. , Department of Pathology, NYU Langone Medical Center, New York, NY, USA. , Department of Pathology, NYU Langone Medical Center, New York, NY, USA. , Department of Urology, NYU Langone Medical Center, New York, NY, USA. , Department of Urology, NYU Langone Medical Center, New York, NY, USA. , Department of Urology, NYU Langone Medical Center, New York, NY, USA; Department of Radiology, NYU Langone Medical Center, New York, NY, USA.  

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