Patient selection determines the prostate cancer yield of dynamic contrast-enhanced magnetic resonance imaging-guided transrectal biopsies in a closed 3-Tesla scanner

Anurag K. Singh, Axel Krieger, Jean Baptiste Lattouf, Peter Guion, Robert L. Grubb, Paul S. Albert, Greg Metzger, Karen Ullman, Sharon Smith, Gabor Fichtinger, Iclal Ocak, Peter Choyke, Cynthia Ménard, Jonathan Coleman

Research output: Contribution to journalArticle

Abstract

Study Type - Diagnostic (non-consecutive cohort study) Level of Evidence 3b OBJECTIVE: To evaluate the cancer yield of transrectal prostate biopsies in a 3-T magnetic resonance imaging (MRI) scanner in patients with elevated prostate specific antigen (PSA) levels and recent negative transrectal ultrasonography (TRUS)-guided prostate biopsies. PATIENTS AND METHODS: Between July 2004 and November 2005, patients with at least one previous negative prostate biopsy within the previous 12 months had MRI-guided biopsy of the prostate in a 3-T MRI scanner. Patients with previous positive biopsies for cancer were excluded. Target selection was based on T2-weighted imaging and dynamic contrast-enhanced (DCE) imaging studies. RESULTS: Thirteen patients were eligible; their median (range) age was 61 (47-74) years and PSA value 4.90 (1.3-12.3) ng/mL. Most patients had one previous negative biopsy (range 1-4). Four patients had a family history of prostate cancer. There were 37 distinct targets based on T2-weighted imaging. Fifteen of 16 distinct DCE abnormalities were co-localized with a target based on T2-weighted imaging. Despite this correlation, only one of 13 patients had a directed biopsy positive for cancer. Including systematic biopsies, two of 13 patients had a biopsy positive for prostate cancer. One patient had prostate intraepithelial neoplasia and one had atypical glands in the specimen. CONCLUSION: The prostate-cancer yield of transrectal biopsies in a 3-T MRI scanner, among patients with recent negative TRUS-guided prostate biopsies, is similar to repeat systematic TRUS-guided biopsy. DCE correlates with T2-imaging but does not appear to improve prostate cancer yield in this population.

Original languageEnglish (US)
Pages (from-to)181-185
Number of pages5
JournalBJU International
Volume101
Issue number2
DOIs
StatePublished - Jan 2008

Keywords

  • Biopsy
  • Dynamic contrast enhancement
  • Image-guided
  • PSA level
  • TRUS

ASJC Scopus subject areas

  • Urology

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    Singh, A. K., Krieger, A., Lattouf, J. B., Guion, P., Grubb, R. L., Albert, P. S., Metzger, G., Ullman, K., Smith, S., Fichtinger, G., Ocak, I., Choyke, P., Ménard, C., & Coleman, J. (2008). Patient selection determines the prostate cancer yield of dynamic contrast-enhanced magnetic resonance imaging-guided transrectal biopsies in a closed 3-Tesla scanner. BJU International, 101(2), 181-185. https://doi.org/10.1111/j.1464-410X.2007.07219.x