To report our experience with a combination of prostate MRI and transperineal ultrasound biopsy for evaluating the prostate in patients with elevated PSA who have previously undergone abdominoperineal resection.
We reviewed the records of 11 patients over a 5 year period with a history of abdominoperineal resection and clinical suspicion of prostate cancer due to elevated PSA levels. All patients underwent multiparametric MRI at our institution prior to biopsy. MR diagnoses were validated either by transperineal ultrasound biopsy (Likert 3-5) guided by visual registration or clinical follow-up >6 months (Likert 1-2).
All 7 cases with highly suspicious lesions (Likert 4-5) on MRI demonstrated cancer, one case of Gleason 3+3 and six of Gleason ≥3+4 disease. Two cases with Likert 3 MR lesions revealed benign tissue upon biopsy. 2 patients with no suspicious lesions on MRI were followed-up clinically, with PSA levels remaining stable over a mean period of 17.5 months (range 7-28 months).
The use of pre-biopsy multiparametric prostate MRI and subsequent cognitively targeted transperineal biopsy guided by visual registration can aid in the diagnostic pathway of patients with abdominoperineal resection and a suspicion of prostate cancer.
Urology. 2016 May 04 [Epub ahead of print]
Nienke L Hansen, Iztok Caglic, Laurence H Berman, Christof Kastner, Andrew Doble, Tristan Barrett
Department of Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Aachen, Germany; CamPARI Clinic, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK., CamPARI Clinic, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK; Department of Radiology, University Medical Centre Maribor, Maribor, Slovenia., CamPARI Clinic, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK; Department of Radiology, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK., CamPARI Clinic, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK; Department of Urology, Addenbrooke's Hospital, Cambridge, UK., CamPARI Clinic, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK; Department of Urology, Addenbrooke's Hospital, Cambridge, UK., CamPARI Clinic, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK; Department of Radiology, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK. Electronic address: .