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La radiologia medica

, Volume 123, Issue 3, pp 227–234 | Cite as

MRI/US fusion-guided biopsy: performing exclusively targeted biopsies for the early detection of prostate cancer

  • Maurizio Del Monte
  • Costantino Leonardo
  • Vincenzo Salvo
  • Marcello Domenico Grompone
  • Martina Pecoraro
  • Arnaldo Stanzione
  • Riccardo Campa
  • Francesco Vullo
  • Alessandro Sciarra
  • Carlo Catalano
  • Valeria Panebianco
ONCOLOGY IMAGING

Abstract

Purpose

The aim of this study was to validate the role of MR/Ultrasound Fusion-Guided Targeted Biopsy as a first diagnostic modality in subjects with clinical suspicion of prostate cancer (PCa).

Materials and methods

108 men (age range 46–78 years) with clinical suspicion for PCa (PSA > 4 ng/mL) underwent multiparametric MRI of the prostate (mpMRI) and, when suspicious lesion were found (according to the PIRADSv2 scoring system), targeted biopsy was performed. All patients without significant alteration patterns at mpMRI have been referred for follow-up at 1 year.

Results

91/108 patients showed on the mpMRI highly suspicious lesions (PIRADS 4 and 5); the remaining 17/108 patients revealed no significant alteration consistent with PCa (PIRADS 3). Among the first group of patients, 58/91 proved to be positive for PCa on the pathology report: 24 patients had a Gleason Score (GS) 6 (3 + 3); 18 patients GS 7 of which 7 (3 + 4) and 11 (4 + 3); 14 patients GS 8 (4 + 4); two patients GS 9 (5 + 4); 33 proved to be negative. Overall cancer detection rate (CDR) was 63%. However, the CDR rises significantly, up to 77%, after the 53 initial consecutive biopsies that were performed (p < 0,05) and thus identified as part of the learning curve. Patients of the second group (17/108) have been followed with serial PSA assessments, clinical reevaluation, and follow-up mpMRI.

Conclusion

Performing exclusively targeted MR/Ultrasound Fusion-Guided biopsies for the diagnosis of PCa in patients with suspicious PSA levels (> 4 ng/mL) increases the detection rate of clinically significant cancer, changing both the therapeutic options and the prognosis.

Keywords

Prostate cancer Multiparametric magnetic resonance Targeted biopsy 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Copyright information

© Italian Society of Medical Radiology 2017

Authors and Affiliations

  • Maurizio Del Monte
    • 1
  • Costantino Leonardo
    • 2
  • Vincenzo Salvo
    • 1
  • Marcello Domenico Grompone
    • 1
  • Martina Pecoraro
    • 1
  • Arnaldo Stanzione
    • 3
  • Riccardo Campa
    • 1
  • Francesco Vullo
    • 1
  • Alessandro Sciarra
    • 2
  • Carlo Catalano
    • 1
  • Valeria Panebianco
    • 1
  1. 1.Prostate Unit—Department of Radiological Sciences, Oncology and PathologySapienza University of RomeRomeItaly
  2. 2.Department of UrologySapienza UniversityRomeItaly
  3. 3.Department of Advanced Biomedical SciencesUniversity “Federico II”NaplesItaly

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