High cancer detection rate using cognitive fusion – targeted transperineal prostate biopsies

Vol. 43 (4): 600-606, July – August, 2017

doi: 10.1590/S1677-5538.IBJU.2016.0511


ORIGINAL ARTICLE

Snir Dekalo 1, Haim Matzkin 1, Nicola J Mabjeesh 1
1 Department of Urology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Israel

 

ABSTRACT

Objective MRI of the prostate improves diagnostic accuracy of prostate cancer. Dif­ferent fusion approaches with transrectal ultrasound images are employed. Objective: To determine detection rate of prostate cancer in men undergoing transperineal MRI-based cognitive fusion biopsy.

Materials and Methods: One hundred and sixty-four consecutive men underwent a multiple-core prostate transperineal biopsy. Univariable and multivariable logistic re­gression analyses were used to address the relationship between clinical parameters and prostate cancer detection rate.

Results: One hundred and fourteen patients underwent mpMRI prior to the transperi­neal biopsy, 52 (45%) were diagnosed with prostate cancer, of them, 36 had Gleason score ≥7 (69%). Among these 114 patients, 82 had suspicious lesions on MRI, and 43 of them were diagnosed with cancer (52%). On multivariate analysis, the most significant independent predictive factors were PSA density (P<0.001) and suspicious MRI lesion (P=0.006). Men with a PSA density of more than 0.22 and a suspicious lesion on MRI had a detection rate of 78%. Detection rate among 50 patients with no MRI study prior to this biopsy was 26%.

Conclusions: This study showed that among a group of mostly multi-biopsied patients, the presence of mpMRI lesions and high PSA density values helped to detect clinically significant prostate cancer using cognitive MRI/TRUS fusion biopsies.

Keywords:  Magnetic Resonance Imaging; Prostatic Neoplasms; Biopsy

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