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

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

Research output: Contribution to journalArticlepeer-review

27 Scopus citations

Abstract

Objective 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. Materials and Methods 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. Results 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. Conclusion 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.

Original languageEnglish (US)
Pages (from-to)416.e9-416.e14
JournalUrologic Oncology: Seminars and Original Investigations
Volume34
Issue number9
DOIs
StatePublished - Sep 1 2016

Keywords

  • Biopsy
  • Early detection of cancer
  • Magnetic Resonance Imaging
  • Prostatic Neoplasms
  • Risk assessment

ASJC Scopus subject areas

  • Oncology
  • Urology

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