Accuracy of Magnetic Resonance Imaging/Ultrasound Fusion Targeted Biopsies to Diagnose Clinically Significant Prostate Cancer in Enlarged Compared to Smaller Prostates

No AccessJournal of UrologyAdult Urology1 Sep 2015Accuracy of Magnetic Resonance Imaging/Ultrasound Fusion Targeted Biopsies to Diagnose Clinically Significant Prostate Cancer in Enlarged Compared to Smaller Prostates Arachk de Gorski, Morgan Rouprêt, Benoit Peyronnet, Chloé Le Cossec, Benjamin Granger, Eva Comperat, Olivier Cussenot, Raphaële Renard-Penna, and Pierre Mozer Arachk de GorskiArachk de Gorski Academic Department of Urology, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpétrière, Paris, France , Morgan RouprêtMorgan Rouprêt Academic Department of Urology, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpétrière, Paris, France GRC5, ONCOTYPE-Uro, Institut Universitaire de Cancérologie, Université Pierre et Marie Curie-Université Paris 06, Paris, France , Benoit PeyronnetBenoit Peyronnet Academic Department of Urology, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpétrière, Paris, France , Chloé Le CossecChloé Le Cossec Academic Department of Biostatistics, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpétrière, Paris, France , Benjamin GrangerBenjamin Granger Academic Department of Biostatistics, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpétrière, Paris, France , Eva ComperatEva Comperat Academic Department of Pathology, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpétrière, Paris, France , Olivier CussenotOlivier Cussenot Academic Department of Urology, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpétrière, Paris, France GRC5, ONCOTYPE-Uro, Institut Universitaire de Cancérologie, Université Pierre et Marie Curie-Université Paris 06, Paris, France , Raphaële Renard-PennaRaphaële Renard-Penna Academic Department of Radiology, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpétrière, Paris, France , and Pierre MozerPierre Mozer Academic Department of Urology, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpétrière, Paris, France Institute for Intelligent Systems and Robotics, Université Pierre et Marie Curie-Université Paris 06, Paris, France View All Author Informationhttps://doi.org/10.1016/j.juro.2015.03.025AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We assessed the accuracy of magnetic resonance imaging/transrectal ultrasound fusion biopsies to diagnose prostate cancer according to gland size. Materials and Methods: A prospective study was performed in 232 men with a first round biopsy, multiparametric magnetic resonance imaging with a lesion, a Likert score of 2 or greater and prostate specific antigen less than 10 ng/ml. All men underwent a standard 12-core protocol plus a protocol of 2 or 3 targeted cores. Significant prostate cancer was defined as at least 1 core with a Gleason score of 7 (3 + 4) or 6 with a greater than 4 mm maximal cancer core length. Results: Mean ± SD patient age was 64 ± 6.4 years, mean prostate specific antigen was 6.65 ± 1.8 ng/ml and mean prostate volume was 40 ± 24.3 ml. The overall detection rate of clinically significant prostate cancer was 44%. The detection rate of clinically significant prostate cancer by magnetic resonance imaging-transrectal ultrasound fusion guided biopsy was 77% for prostate glands less than 30 cm3, and 61%, 47% and 34% for glands 30 to less than 38.5, 38.5 to less than 55 and 55 to 160 cm3, respectively (p = 0.001). Differences in prostate cancer detection rates between the standard and targeted protocols were not significant for patients with a prostate volume of 40 cm3 or less (p = 0.8). Conversely 12 patients with a prostate volume greater than 40 cm3 had clinically significant prostate cancer using the targeted but not the standard protocol and in 3 prostate cancer was detected by the standard but not the targeted protocol (p = 0.04). Conclusions: Magnetic resonance imaging-transrectal ultrasound fusion biopsies increased the yield of first round prostate biopsies in patients with a prostate volume greater than 40 cm3. References 1 : Cancer statistics, 2013. CA Cancer J Clin2013; 63: 11. Google Scholar 2 : EAU guidelines on prostate cancer. Part 1: screening, diagnosis, and local treatment with curative intent-update 2013. Eur Urol2014; 65: 124. Google Scholar 3 : Is it possible to predict low-volume and insignificant prostate cancer by core needle biopsies?. APMIS2013; 121: 257. 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Google Scholar © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byCosta D, Lotan Y, Rofsky N, Roehrborn C, Liu A, Hornberger B, Xi Y, Francis F and Pedrosa I (2015) Assessment of Prospectively Assigned Likert Scores for Targeted Magnetic Resonance Imaging-Transrectal Ultrasound Fusion Biopsies in Patients with Suspected Prostate CancerJournal of Urology, VOL. 195, NO. 1, (80-87), Online publication date: 1-Jan-2016.Dall'Era M and Carroll P (2015) What is the Optimal Way to Select Candidates for Active Surveillance of Prostate Cancer?Journal of Urology, VOL. 194, NO. 3, (615-616), Online publication date: 1-Sep-2015. Volume 194Issue 3September 2015Page: 669-673 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.Keywordsprostatic neoplasmsbiopsyultrasonographymagnetic resonance imagingdiagnostic imagingMetrics Author Information Arachk de Gorski Academic Department of Urology, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpétrière, Paris, France More articles by this author Morgan Rouprêt Academic Department of Urology, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpétrière, Paris, France GRC5, ONCOTYPE-Uro, Institut Universitaire de Cancérologie, Université Pierre et Marie Curie-Université Paris 06, Paris, France More articles by this author Benoit Peyronnet Academic Department of Urology, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpétrière, Paris, France More articles by this author Chloé Le Cossec Academic Department of Biostatistics, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpétrière, Paris, France More articles by this author Benjamin Granger Academic Department of Biostatistics, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpétrière, Paris, France More articles by this author Eva Comperat Academic Department of Pathology, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpétrière, Paris, France More articles by this author Olivier Cussenot Academic Department of Urology, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpétrière, Paris, France GRC5, ONCOTYPE-Uro, Institut Universitaire de Cancérologie, Université Pierre et Marie Curie-Université Paris 06, Paris, France More articles by this author Raphaële Renard-Penna Academic Department of Radiology, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpétrière, Paris, France More articles by this author Pierre Mozer Academic Department of Urology, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpétrière, Paris, France Institute for Intelligent Systems and Robotics, Université Pierre et Marie Curie-Université Paris 06, Paris, France More articles by this author Expand All Advertisement PDF downloadLoading ...