Vol. 42 (5): 897-905, September – October, 2016
Thais Caldara Mussi 1, Rodrigo Gobbo Garcia 2, Marcos Roberto Gomes de Queiroz 2, Gustavo Caserta Lemos 3, Ronaldo Hueb Baroni 1
1 Departamento de Radiologia e Diagnóstico por Imagem do Hospital Israelita Albert Einstein, São Paulo, SP, Brasil; 2 Departamento de Intervenção Guiada por Imagem do Hospital Israelita Albert Einstein, São Paulo, SP, Brasil; 3 Departamento de Urologia do Hospital Israelita Albert Einstein, São Paulo, SP, Brasil
Objective: To evaluate the diagnostic efficacy of transrectal ultrasonography (US) biopsy with imaging fusion using multiparametric (mp) magnetic resonance imaging (MRI) in patients with suspicion of prostate cancer (PCa), with an emphasis on clinically significant tumors according to histological criteria.
Materials and Methods: A total of 189 consecutive US/MRI fusion biopsies were performed obtaining systematic and guided samples of suspicious areas on mpMRI using a 3 Tesla magnet without endorectal coil. Clinical significance for prostate cancer was established based on Epstein criteria.
Results: In our casuistic, the average Gleason score was 7 and the average PSA was 5.0ng/mL. Of the 189 patients that received US/MRI biopsies, 110 (58.2%) were positive for PCa. Of those cases, 88 (80%) were clinically significant, accounting for 46.6% of all patients. We divided the MRI findings into 5 Likert scales of probability of having clinically significant PCa. The positivity of US/MRI biopsy for clinically significant PCa was 0%, 17.6% 23.5%, 53.4% and 84.4% for Likert scores 1, 2, 3, 4 and 5, respectively.
There was a statistically significant difference in terms of biopsy results between different levels of suspicion on mpMRI and also when biopsy results were divided into groups of clinically non-significant versus clinically significant between different levels of suspicion on mpMRI (p-value <0.05 in both analyzes).
Conclusion: We found that there is a significant difference in cancer detection using US/MRI fusion biopsy between low-probability and intermediate/high probability Likert scores using mpMRI.
Keywords: Prostatic Neoplasms; Magnetic Resonance Imaging; Biopsy; Prostate