Work

Multiparametric magnetic resonance tomography and MRI/TRUS-fusion-biopsy for index lesion detection: correlation with radical prostatectomy specimen

Year: 2015

Type: article

Abstract: We selected 120 consecutive patients who underwent transperineal fusion-biopsy before RP. All men received a saturation biopsy (SB) in addition to targeted biopsies of lesions with PIRADS≥2. On RP specimen, the index lesion was defined as highest Gleason score (GS) or highest tumour volume (TV). GS=3+3 and TV≥1.2ml or GS=3+4 and TV≥0.7ml or GS>3+4 were considered significant PC. We performed Spearmans correlation analysis between mpMRI and RP and Fisher`s test between mpMRI, TB and SB. Overall, 120 index lesions and 71 non-index lesions were detected. 107 index and 51 non-index lesions harbored significant PC. MpMRI detected 110/120(91.7%) index lesions, while TB alone diagnosed only 96/120(80.0%) and SB alone 110/120(91.7%). The combination of SB and TB detected 115/120(95.8%) index foci. The combination of TB and SB outperformed TB alone ( p =0.017) for detection of all significant PC. Additionally, TB performed significantly worse compared to SB alone for all significant tumour detection ( p =0.034). Spearmans correlation coefficient for index lesion concordance between mpMRI and RP was 0.865( p <0.001). TB provided greatest benefit in men undergoing repeat biopsy. MpMRI detected 91.7% index lesions compared to RP. However, TB alone missed 21.5% of all significant foci. Thus, the combination of both biopsy approaches should be incorporated in the biopsy workflow to predict PC most accurately.

Source: Cancer Imaging

DOI: 10.1186/1470-7330-15-s1-s1