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Multiparametric MRI and MRI/TRUS Fusion Guided Biopsy for the Diagnosis of Prostate Cancer

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Molecular & Diagnostic Imaging in Prostate Cancer

Part of the book series: Advances in Experimental Medicine and Biology ((AEMB,volume 1126))

Abstract

Purpose of this chapter To demonstrate the timing, benefits, limitations and current controversies of multiparametric magnet resonance imaging (mpMRI) combined with fusion guided biopsy and consider how additional incorporation of multivariable risk stratification might further improve prostate cancer (PC) diagnosis.

Recent findings MpMRI has been shown to add important information to the diagnostic pathway for prostate cancer. Fusion biopsy has also shown advantages in comparison to standard practice for biopsy-naïve men and men with previous biopsy in large prospective studies providing level 1b evidence. Adding upfront multivariable risk stratification followed by or combined with mpMRI diagnostic accuracy can further be improved. Regarding active surveillance (AS), mpMRI in combination with fusion biopsy can support initial candidate selection and may help to monitor disease progression. However, mpMRI and fusion biopsy are not without failure and conflicting data exists to what extend (systematic) biopsies can be omitted.

Summary The integration of mpMRI into the diagnostic pathway for PC can add important information for further decision making, yet more prospective and randomized data is needed to establish reliable procedure standards after mpMRI acquisition.

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Abbreviations

ADC:

Apparent diffusion coefficient

AS:

Active surveillance

AUC:

Area under the curve

DRE:

Digital rectal examination

ERSPC:

European randomized study of screening for prostate cancer

GS:

Gleason score

mpMRI:

Multiparametric magnet resonance imaging

NPV:

Negative predictive value

PCa:

Prostate cancer

PPV:

Positive predictive value

PSA:

Prostate specific antigen

ROC:

Receiver operating characteristics

SB:

Systematic biopsy

sPCa:

Significant prostate cancer

TB:

targeted mpMRI fusion biopsy

TRUS:

Transrectal ultrasound

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Acknowledgements

None. Conflicts of interest: Jan P. Radtke is a consultant for UroNav, Saegeling Medizintechnik, Siemens Healthineers, MedCom and Bender Gruppe. The remaining authors report no potential conflicts of interest.

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Authors and Affiliations

  1. Department of Urology, University Hospital Heidelberg, Heidelberg, Germany

    Viktoria Schütz, Claudia Kesch, Svenja Dieffenbacher, Markus Hohenfellner & Jan Philipp Radtke

  2. The Vancouver Prostate Centre, University of British Columbia, Vancouver, Canada

    Claudia Kesch

  3. Department of Radiology, German Cancer Research Center (dkfz), Heidelberg, Germany

    David Bonekamp & Jan Philipp Radtke

  4. Department of Urology, University Hospital Essen, Essen, Germany

    Boris Alexander Hadaschik

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  1. Viktoria Schütz
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  2. Claudia Kesch
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Correspondence to Viktoria Schütz .

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  1. Department of Veterinary Pathobiology, Univ of Missouri-Columbia, Columbia, MO, USA

    Heide Schatten

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Schütz, V. et al. (2018). Multiparametric MRI and MRI/TRUS Fusion Guided Biopsy for the Diagnosis of Prostate Cancer. In: Schatten, H. (eds) Molecular & Diagnostic Imaging in Prostate Cancer. Advances in Experimental Medicine and Biology, vol 1126. Springer, Cham. https://doi.org/10.1007/978-3-319-99286-0_5

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