Abstract
Purpose
The purpose this study is to evaluate the efficacy of multiparametric ultrasound-targeted biopsies in patients undergoing initial biopsy of the prostate for the suspicion of prostate cancer.
Materials and methods
A total of 167 patients who are biopsy naïve underwent multiparametric ultrasound-targeted biopsy of the prostate. All patients had a transrectal ultrasound which included gray-scale evaluation and color Doppler evaluation. 12-core biopsies were performed on all patients, based on sextant anatomy; however, all cores were directed toward visually abnormal areas of the prostate as identified by multiparametric ultrasound, when such areas were present.
Results
Of 167 patients undergoing biopsy, a total of 111 (66.5%) were positive for cancer. Of these, 78 (70.3%) had a Gleason grade ≥ 7 and 33 (29.7%) had a Gleason grade ≤ 6. Of those undergoing radical prostatectomy 29 of 38 (76.3%) had biopsy Gleason grade ≥ 7, while nine of 38 (23.7%) had a Gleason grade ≤ 6. Only four of 38 (10.5%) patients who had final pathologic staging underwent surgical therapy for disease of low-malignant potential (Gleason ≤ 6).
Conclusion
On initial biopsy for prostate cancer, multiparametric ultrasound-targeted biopsy compares favorably to the published performance of multiparametric MRI-TRUS fusion-targeted biopsy in terms of positive biopsy rate and the detection of disease of low-malignant potential.
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References
Chu K, Tarone R, Freeman H (2003) Trends in prostate cancer mortality among black men and white men in the United States. Cancer 97(6):1507–1516
American Cancer Society (2017) Cancer Facts & Figures 2017. American Cancer Society, Atlanta
Hankey B, Feuer E, Clegg L et al (1999) Cancer surveillance series: interpreting trends in prostate cancer—Part I: evidence of the effects of screening in recent prostate cancer incidence, mortality and survival rates. J Natl Cancer Inst 91:1017–1024
Wallis C, Haider M, Nam R (2017) Role of mpMRI of the prostate in screening for prostate cancer. Transl Androl Urol. 6(3):464–471
Mendhiratta N, Rosenkrantz A, Meng X, Wysock JS, Fenstermaker M, Huang R, Deng FM, Melamed J, Zhou M, Huang WC, Lepor H, Taneja SS (2015) Magnetic resonance imaging-ultrasound fusion targeted prostate biopsy in a consecutive cohort of men with no previous biopsy: reduction of over detection through improved risk stratification. J Urol 194:1601–1606
Pokorny MR, de Rooij M, Duncan E, Schröder F, Parkinson R, Barentsz J, Thompson L (2014) Prospective study of diagnostic accuracy comparing prostate cancer detection by transrectal ultrasound-guided biopsy versus magnetic resonance (MR) imaging with subsequent MR-guided biopsy in men without previous prostate biopsies. Eur Urol 66:22–29
Haffner J, Lemaitre L, Puech P, Haber GP, Leroy X, Jones JS, Villers A (2011) Role of magnetic resonance imaging before initial biopsy: comparison of magnetic resonance imaging-targeted and systematic biopsy for significant prostate cancer detection. BJU Int 108:E171–E178
Sugano D, Sidana A, Calio B, Cobb K, Turkby B, Pinto P (2017) MRI-targeted biopsy: is systematic biopsy obsolete? Can J Urol 24(4):8876–8882
Valerio M, Donaldson I, Emberton M, Ehdaie B, Hadaschik B, Marks L, Mozer P, Rastinehad A, Ahmed H (2015) Detection of clinically significant prostate cancer using magnetic resonance imaging-ultrasound fusion targeted biopsy: a systematic review. Eur Urol 68:8–19
Fütterer J, Briganti A, Visschere P, Emberton M, Giannarini G, Kirkham A, Taneja S, Thoeny H, Villeirs G, Villers A (2015) Can clinically significant prostate cancer be detected with multiparametric magnetic resonance imaging? A systematic review of the literature. Eur Urol 68:1045–1053
Schoots I, Roobol M, Nieboer D, Bangma C, Steyerberg E, Hunink M (2015) Magnetic resonance imaging-targeted biopsy may enhance the diagnostic accuracy of significant prostate cancer detection compared to standard transrectal ultrasound-guided biopsy: a systematic review and meta-analysis. Eur Urol 68:438–450
Baco E, Rud E, Eri L, Moen G, Vlatkovic L, Svindland A, Eggesbo H, Ukimura O (2016) A randomized controlled trial to assess and compare the outcomes ot two-core prostate biopsy guided by fused magnetic resonance and transrectal ultrasound images and traditional 12-core systematic biopsy. Eur Urol 69:149–156
Haffner J, Lemaitre L, Puech P et al (2011) Role of magnetic resonance imaging before initial biopsy: comparison of magnetic resonance imaging-targeted and systematic biopsy for significant prostate cancer detection. BJU In 108:E171–E178
Belas O, Klap J, Cornud F et al (2012) Prebiopsy multiparametic MRI of the prostate: the end of randomized biopsies? Prog Urol 22:583–589
Rehfuss A, Nakada S, Pearle MS, Thrasher JB, Feustel PJ, Kogan BA (2017) Use of nonprostate ultrasound in urology practice. Urol Pract 4(5):430–435
Acknowledgements
Thanks to Angela Clark, RHIA for her assistance with data collection and manuscript editing.
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Fulgham, P.F. Multiparametric ultrasound-targeted biopsy compares favorably to multiparametric MRI-transrectal ultrasound fusion-targeted biopsy on initial biopsy of men at risk for prostate cancer. World J Urol 36, 713–718 (2018). https://doi.org/10.1007/s00345-018-2187-9
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DOI: https://doi.org/10.1007/s00345-018-2187-9