The aim of this study was to determine the tumour detection rate of magnetic resonance-guided biopsy (MRGB) in the supine position for significant prostate cancer in an inhomogeneous patient cohort.
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Thirty-two consecutive patients with a total prostate-specific antigen > 4 ng/ml and/or a tumour-suspicious palpable lesion upon digital rectal examination and a cancer-suspicious region in multiparametric magnetic resonance imaging (MRI) underwent MRGB in a standard 1. 5 T magnet. Diagnostic MRI was performed in 20 patients at the authors' institute and 12 men at another location. Eight patients were investigated at 3 T and 24 at 1. 5 T. Twenty men had prior negative biopsies and 12 were biopsy naïve. All biopsies were performed in the supine position using a table-mounted device and an 18 G biopsy gun.
The overall tumour detection rate was 53% (17/32). Two cores (median; range 1-4) were extracted. Clinically significant cancers were found in 94% (16/17). None of the patients showed any postbiopsy complications. The prostate volumes of patients with cancer were significantly lower (39. 3 ml) than those of men without cancer (49. 7 ml). No significant differences were found between the numbers of tumour-positive and tumour-negative collected cores. In a median follow-up of 14 months, no cancer was detected in the negative biopsy group.
MRGB in the supine position can be a valuable tool to detect significant prostate cancer, even in a patient cohort with different prebiopsy pathways. The biopsy method could be a reasonable alternative to MRGB in the prone position.
Scandinavian journal of urology. 2015 Nov 05 [Epub ahead of print]
Karl Engelhard, Reinhart Kühn, Artur Osten, Katja Bogner, Anton Dworak, Lars Lübke, Florian Schneider
a Institut für Radiologie, Krankenhaus Martha-Maria , Nürnberg , Germany. , b Urologische Klinik, Krankenhaus Martha-Maria , Nürnberg , Germany. , a Institut für Radiologie, Krankenhaus Martha-Maria , Nürnberg , Germany. , a Institut für Radiologie, Krankenhaus Martha-Maria , Nürnberg , Germany. , c Pathologisches Institut, Klinikum Fürth , Fürth , Germany. , b Urologische Klinik, Krankenhaus Martha-Maria , Nürnberg , Germany. , a Institut für Radiologie, Krankenhaus Martha-Maria , Nürnberg , Germany.