Document Detail


Prospective evaluation of MRI-guided in-bore prostate biopsy versus systematic transrectal ultrasound (TRUS)-guided prostate biopsy in biopsy-naïve men with elevated prostate-specific antigen (PSA) levels.
MedLine Citation:
PMID:  24866597     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
PURPOSE: MRI-guided biopsies are increasingly used for prostate cancer (PCa) diagnosis. However, there is a lack of well controlled prospective trials to support this treatment method. The aim of this study was to prospectively compare the MRI-guided in-bore biopsy with the standard systematic TRUS-guided biopsy in biopsy naïve men with elevated PSA.
MATERIALS AND METHODS: Prospective inclusion of 132 biopsy-naïve men (ClinicalTrials.gov, NCT01553838) with elevated PSA (>4 ng/ml). After functional multiparametric MRI at 3-TESLA, patients were referred for a MRI-guided in-bore biopsy of prostate lesions (maximum three) followed by a standard systematic TRUS-guided biopsy (12 cores). Analysis of detection rates for PCa and significant PCa was performed (>5 mm total cancer length or any Gleason pattern >3).
RESULTS: 128 patients (age 66.1±8.1 years; median PSA 6.7 ng/ml, lower quartile 5.1 ng/ml, upper quartile 9.0 ng/ml) met all study requirements. Both biopsy methods produced the same detection rate of 53.1% (for significant PCa: TRUS-biopsy 79.4%; MRI-guided biopsy 85.3%). 7.8% of clinically significant PCa were missed by the MRI-guided in-bore biopsy and 9.4% by the TRUS-biopsy. MRI-guided in-bore biopsy required significantly less cores (p<0.01) and showed higher percentage of cancer involvement per biopsy core (p<0.01). The combination of both methods showed a detection rate of 60.9% (significant PCa: 82.1%).
CONCLUSIONS: MRI-guided in-bore biopsies and systematic TRUS-guided biopsies achieved equally high detection rates in biopsy-naïve patients with elevated PSA levels. MRI-guided in-bore biopsies required significantly less cores and showed a significantly higher percentage of cancer involvement per biopsy core.
Authors:
Michael Quentin; Dirk Blondin; Christian Arsov; Lars Schimmöller; Andreas Hiester; Erhard Godehardt; Peter Albers; Gerald Antoch; Robert Rabenalt
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-5-24
Journal Detail:
Title:  The Journal of urology     Volume:  -     ISSN:  1527-3792     ISO Abbreviation:  J. Urol.     Publication Date:  2014 May 
Date Detail:
Created Date:  2014-5-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376374     Medline TA:  J Urol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2014 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
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