Perineural Invasion in Prostate Cancer Is More Frequently Detected by Multiparametric MRI Targeted Biopsy Compared With Standard Biopsy.

Multiparametric magnetic resonance imaging (MP-MRI) incorporates high-resolution imaging to aid in the detection of lesions suspicious for prostate cancer (PCa). MP-MRI and MRI/ultrasound (US) fusion-guided prostate biopsy has been shown to detect more clinically significant PCa.

However, to date there have been no studies in fusion-guided biopsies evaluating the detection of perineural invasion. We assessed whether MRI/US fusion-guided prostate biopsies diagnosed more perineural invasion compared with standard techniques. We reviewed our prospectively maintained prostate biopsy database evaluating men who underwent MP-MRI and MRI/US fusion-guided prostate biopsy between January 2014 and June 2015. Patients underwent MP-MRI followed by 12-core standard biopsy and fusion-guided biopsies of MRI-identified lesions. Patients' clinical, radiologic, and pathologic findings were reviewed. A total of 114 patients underwent both 12-core standard biopsy and MRI/US fusion-guided prostate biopsy. The mean age and prebiopsy prostate-specific antigen of our patient cohort was 64. 5 years and 10. 7 ng/mL, respectively. Sixty-four of 114 (56%) patients were found to have PCa. Perineural invasion was identified in 19/64 (30%) patients. Of the patients with perineural invasion, 9 were diagnosed on the fusion biopsy only, 2 were diagnosed on standard biopsy only, and 8 were diagnosed on both standard and fusion biopsies. Perineural invasion was significantly associated with higher prostate-specific antigen and with a higher number of cores involved by cancer (P

The American journal of surgical pathology. 2015 Oct 29 [Epub ahead of print]

Jennifer B Gordetsky, Jeffrey W Nix, Soroush Rais-Bahrami

Departments of *Pathology †Urology ‡Radiology, University of Alabama at Birmingham, Birmingham, AL.