Magnetic resonance imaging-targeted vs. conventional transrectal ultrasound-guided prostate biopsy: Single-institution, matched cohort comparison

Eric H. Kim, Goutham Vemana, Michael Johnson, Joel M. Vetter, Adam J. Rensing, Marshall C. Strother, Kathryn J. Fowler, Gerald L. Andriole

Research output: Contribution to journalArticle

Abstract

Objectives: To compare magnetic resonance imaging-targeted biopsy (MRITB) and conventional transrectal ultrasound-guided biopsy (TRUSGB) in the detection of prostate cancer (PCa) at our institution. Methods: Our prospective registry of patients undergoing prostate MRITB from December 2010 to July 2013 was analyzed. Patients were matched one-to-one to patients who underwent TRUSGB based on the following characteristics: age, prostate-specific antigen level, prostate volume, race, family history of PCa, initial digital rectal examination (DRE), prior use of 5-alpha reductase inhibitor, and prior diagnosis of PCa. MRITB was performed using a TargetScan system with the patient under general anesthesia. Magnetic resonance imaging suspicious regions (MSRs) were targeted with cognitive registration, and a full TargetScan template biopsy (TSTB) was also performed. Results: In total, 34 MRITB patients were matched individually to 34 TRUSGB patients. As compared with TRUSGB, patients who underwent MRITB had a greater overall rate of PCa detection (76% vs. 56%, P = 0.12) and a significantly higher number with Gleason score≥7 (41% vs. 15%, P = 0.03), whereas the rates of Gleason score 6 PCa detection were similar between MRITB and TRUSGB (35% vs. 41%, P = 0.80). As compared with the TSTB, magnetic resonance imaging suspicious regions-directed biopsies during MRITB had a significantly higher overall PCa detection (54% vs. 24%, P<0.01) and Gleason score≥7 PCa detection (25% vs. 8%, P<0.01). When compared with TSTB, TRUSGB had similar detection rates for benign prostate tissue (76% vs. 79%, P = 0.64), Gleason score 6 PCa (16% vs. 14%, P = 0.49), and Gleason score ≥7 PCa detection (8% vs. 7%, P = 1.0). Conclusions: Cognitive registration MRITB significantly improves the detection of Gleason score≥7 PCa as compared with conventional TRUSGB.

Original languageEnglish (US)
Pages (from-to)109.e1-109.e6
JournalUrologic Oncology: Seminars and Original Investigations
Volume33
Issue number3
DOIs
StatePublished - Mar 1 2015
Externally publishedYes

Keywords

  • Magnetic resonance imaging
  • Prostate biopsy
  • Prostate cancer
  • Targeted biopsy

ASJC Scopus subject areas

  • Oncology
  • Urology

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