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Endorectal multiparametric 3-tesla magnetic resonance imaging associated with systematic cognitive biopsies does not increase prostate cancer detection rate: a randomized prospective trial

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Abstract

Purpose

To investigate prostate cancer (PC) detection rate, employing endorectal multiparametric 3-tesla magnetic resonance imaging (MRI) driving subsequent cognitive systematic prostatic biopsy (CSPB) versus a homogenous group of patients who did not undergo endorectal MRI.

Materials and methods

A series of patients with a first negative biopsy were enrolled in the study. Patients were randomized into two groups: Group A: patients underwent MRI and subsequent CSPB; Group B: patients that did not undergo MRI. Each patient underwent a 13-core sampling. Patients from Group A had four cores more for each MRI suspected lesion. The cancer detection rate was calculated for each group with regard to possible matches or mismatches between MRI evidence and pathological reports.

Results

Two hundred consecutive patients were investigated. Fifty out of 200 (25 %) patients had a diagnosis of PC, 24 in Group A and 26 in Group B. In Group A, 67 patients (67 %) were positive for suspected lesions at the MRI. The mismatch between MRI findings and the CSPB outcome was 61 % with an MRI-driven detection rate of 15 %. Group B detection rate was 26 % with no significant differences versus Group A (P = NS). Patient discomfort was higher in Group A (82 %). The accuracy of CSPB was 41 % with a positive predictive value of 22.3 %. This rate is lower in high-grade cancers (11.9 %). The cost-effectiveness was higher in Group A.

Conclusions

Prostate cancer detection rate does not improve by CSPB. The accuracy of CSPB was lower in high-grade PC, and a higher cost was found with CSPB.

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Authors’ contribution

Taverna G, Bozzini G, Grizzi F and Balzarini L involved in project development and data collection and wrote the manuscript. Seveso M, Mrakic F, Bono P, De Franceco O, Buffi N, Lughezzani G, Lazzeri M and Casale P involved in data collection. Mandressi A and Guazzoni GF involved in data analysis.

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Authors and Affiliations

  1. Department of Urology, Humanitas Mater Domni, Via Gerenzano 2, 21053, Castellanza, Varese, Italy

    Gianluigi Taverna, Giorgio Bozzini, Mauro Seveso, Alberto Mandressi, Pietro Bono & Oliviero De Franceco

  2. Humanitas Research Hospital, Humanitas University, Rozzano, Italy

    Fabio Grizzi

  3. Department of Radiology, Humanitas Research Hospital, Rozzano, Italy

    Luca Balzarini & Federica Mrakic

  4. Department of Urology, Humanitas Research Hospital, Rozzano, Italy

    NicolòMaria Buffi, Giovanni Lughezzani, Massimo Lazzeri, Paolo Casale & Giorgio Ferruccio Guazzoni

Authors
  1. Gianluigi Taverna
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  2. Giorgio Bozzini
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  3. Fabio Grizzi
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  4. Mauro Seveso
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  5. Alberto Mandressi
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  6. Luca Balzarini
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  7. Federica Mrakic
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  8. Pietro Bono
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  9. Oliviero De Franceco
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  10. NicolòMaria Buffi
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  11. Giovanni Lughezzani
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  12. Massimo Lazzeri
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  13. Paolo Casale
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  14. Giorgio Ferruccio Guazzoni
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Corresponding author

Correspondence to Gianluigi Taverna.

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Authors state they have no conflict of interests.

Ethical standards

This study has been approved by our local ethics committee and has therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Informed consent

As stated clearly in the text, all the patients gave their informed consent prior to their inclusion in the study. Any details that might disclose their identity has been omitted.

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Taverna, G., Bozzini, G., Grizzi, F. et al. Endorectal multiparametric 3-tesla magnetic resonance imaging associated with systematic cognitive biopsies does not increase prostate cancer detection rate: a randomized prospective trial. World J Urol 34, 797–803 (2016). https://doi.org/10.1007/s00345-015-1711-4

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  • DOI: https://doi.org/10.1007/s00345-015-1711-4

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