Magnetic resonance/transrectal ultrasound fusion biopsy of the prostate compared to systematic 12-core biopsy for the diagnosis and characterization of prostate cancer: multi-institutional retrospective analysis of 389 patients.

To determine the incremental diagnostic value of targeted biopsies added to an extended sextant biopsy scheme on a per-patient, risk-stratified basis in 2 academic centers using different multiparametric magnetic resonance imaging (MRI) protocols, a large group of radiologists, multiple biopsy systems, and different biopsy operators.

All patients with suspected prostate cancer (PCa) who underwent multiparametric MRI of the prostate in 2 academic centers between February 2013 and January 2015 followed by systematic and targeted MRI-transrectal ultrasound fusion biopsy were reviewed. Risk-stratified detection rate using systematic biopsies was compared with targeted biopsies on a per-patient basis. The McNemar test was used to compare diagnostic performance of the 2 approaches.

A total of 389 men met eligibility criteria. PCa was diagnosed in 47% (182/389), 52%(202/389), and 60%(235/389) of patients using the targeted, systematic, and combined (targeted plus systematic) approach, respectively. Compared with systematic biopsy, targeted biopsy diagnosed 11% (37 vs. 26) more intermediate-to-high risk (P<0.0001) and 16% (10 vs. 16) fewer low-risk tumors (P<0.0001). These results were replicated when data from each center, biopsy-naïve patients, and men with previous negative biopsies were analyzed separately.

Targeted MRI-transrectal ultrasound fusion biopsy consistently improved the detection of clinically significant PCa in a large patient cohort with diverse equipment, protocols, radiologists, and biopsy operators as can be encountered in clinical practice.

Urologic oncology. 2016 May 16 [Epub ahead of print]

Guilherme C Mariotti, Daniel N Costa, Ivan Pedrosa, Priscila M Falsarella, Tatiana Martins, Claus G Roehrborn, Neil M Rofsky, Yin Xi, Thais C M Andrade, Marcos R Queiroz, Yair Lotan, Rodrigo G Garcia, Gustavo C Lemos, Ronaldo H Baroni

Department of Interventional Radiology, Hospital Israelita Albert Einstein, São Paulo, Brazil., Department of Radiology and Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX. Electronic address: ., Department of Radiology and Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX., Department of Interventional Radiology, Hospital Israelita Albert Einstein, São Paulo, Brazil., Department of Radiology, Hospital Israelita Albert Einstein, São Paulo, Brazil., Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX., Department of Radiology and Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX., Department of Radiology and Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX., Department of Radiology, Hospital Israelita Albert Einstein, São Paulo, Brazil., Department of Interventional Radiology, Hospital Israelita Albert Einstein, São Paulo, Brazil., Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX., Department of Interventional Radiology, Hospital Israelita Albert Einstein, São Paulo, Brazil., Department of Urology, Hospital Israelita Albert Einstein, São Paulo, Brazil., Department of Radiology, Hospital Israelita Albert Einstein, São Paulo, Brazil.