Prospective comparison of transperineal magnetic resonance imaging/ultrasonography fusion biopsy and transrectal systematic biopsy in biopsy-naïve patients
Objectives To evaluate the value of multiparametric magnetic resonance imaging (mpMRI) in the detection of significant prostate cancer (PCa) and to compare transperineal MRI/ultrasonography fusion biopsy (fusPbx) with conventional transrectal systematic biopsy (sysPbx) in biopsy-naïve patients. Pat...
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| Main Authors: | , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
2018
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| In: |
BJU international
Year: 2017, Volume: 121, Issue: 1, Pages: 53-60 |
| ISSN: | 1464-410X |
| DOI: | 10.1111/bju.14017 |
| Online Access: | Verlag, Volltext: http://dx.doi.org/10.1111/bju.14017 Verlag, Volltext: https://onlinelibrary.wiley.com/doi/abs/10.1111/bju.14017 
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| Author Notes: | Angelika Borkowetz, Boris Hadaschik, Ivan Platzek, Marieta Toma, Georgi Torsev, Theresa Renner, Roman Herout, Martin Baunacke, Michael Laniado, Gustavo Baretton, Jan Philipp Radtke, Claudia Kesch, Markus Hohenfellner, Michael Froehner, Heinz-Peter Schlemmer, Manfred Wirth, Stefan Zastrow |
| Summary: | Objectives To evaluate the value of multiparametric magnetic resonance imaging (mpMRI) in the detection of significant prostate cancer (PCa) and to compare transperineal MRI/ultrasonography fusion biopsy (fusPbx) with conventional transrectal systematic biopsy (sysPbx) in biopsy-naïve patients. Patients and Methods This multicentre, prospective trial investigated biopsy-naïve patients with suspicion of PCa undergoing transperineal fusPbx in combination with transrectal sysPbx (comPbx). The primary outcome was the detection of significant PCa, defined as Gleason pattern 4 or 5. We analysed the results after a study period of 2 years. Results The study included 214 patients. The median (range) number of targeted and systematic cores was 6 (2-15) and 12 (6-18), respectively. The overall PCa detection rate of comPbx was 52%. FusPbx detected more PCa than sysPbx (47% vs 43%; P = 0.15). The detection rate of significant PCa was 38% for fusPbx and 35% for sysPbx (P = 0.296). The rate of missed significant PCa was 14% in fusPbx and 21% in sysPbx. ComPbx detected significantly more significant PCa than fusPbx and sysPbx alone (44% vs 38% vs 35%; P < 0.005). In patients presenting with Prostate Imaging Reporting and Data System (PI-RADS) 4 and 5 lesions there was a higher detection rate of significant PCa than in patients presenting with PI-RADS ≤3 lesions in comPbx (61% vs 14%; P < 0.005). Conclusions For biopsy-naïve men with tumour-suspicious lesions in mpMRI, the combined approach outperformed both fusPbx and sysPbx in the detection of overall PCa and significant PCa. Thus, biopsy-naïve patients may benefit from sysPbx in combination with mpMRI targeted fusPbx. |
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| Item Description: | Published online: 16 September 2017 Gesehen am 23.04.2018 |
| Physical Description: | Online Resource |
| ISSN: | 1464-410X |
| DOI: | 10.1111/bju.14017 |