Title |
Comparative Effectiveness of Targeted Prostate Biopsy Using Magnetic Resonance Imaging Ultrasound Fusion Software and Visual Targeting: a Prospective Study
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Published in |
The Journal of Urology, March 2016
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DOI | 10.1016/j.juro.2016.03.149 |
Pubmed ID | |
Authors |
Daniel J. Lee, Pedro Recabal, Daniel D. Sjoberg, Alan Thong, Justin K. Lee, James A. Eastham, Peter T. Scardino, Hebert Alberto Vargas, Jonathan Coleman, Behfar Ehdaie |
Abstract |
To compare diagnostic outcomes between 2 different techniques for targeting regions-of-interest on prostate multiparametric Magnetic resonance imaging (mpMRI); MRI-ultrasound fusion (MR-F) and visually targeted (VT) biopsy. Patients presenting for prostate biopsy with regions-of-interest on mpMRI underwent MRI-targeted biopsy. For each region-of-interest two VT cores were obtained, followed by 2 cores using an MR-F device. Our primary endpoint was the difference in the detection of high-grade (Gleason ≥7) and any-grade cancer between VT and MR-F, investigated using McNemar's method. Secondary endpoints were the difference in detection rate by biopsy location using a logistic regression model, and difference in median cancer length using Wilcoxon sign-rank test. We identified 396 regions-of-interest in 286 men. The difference in high-grade cancer detection between MR-F biopsy and VT biopsy was -1.4% (95% CI -6.4% to 3.6%; p=0.6); for any-grade cancer the difference was 3.5% (95% CI -1.9% to 8.9%; p=0.2). Median cancer length detected by MR-F and VT were 5.5mm vs. 5.8mm, respectively (p=0.8). MR-F biopsy detected 15% more cancers in the transition zone (p=0.046), and VT biopsy detected 11% more high-grade cancer at the prostate base (p=0.005). Only 52% of all high-grade cancers were detected by both techniques. We found no evidence of a significant difference in the detection of high-grade or any-grade cancer between VT and MR-F biopsy. However, the performance of each technique varied in specific biopsy locations, and the outcomes of both techniques were complementary. Combining VT biopsy and MR-F biopsy may optimize prostate cancer detection. |
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France | 1 | 17% |
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Student > Doctoral Student | 7 | 13% |
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Professor > Associate Professor | 6 | 11% |
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Agricultural and Biological Sciences | 2 | 4% |
Other | 3 | 5% |
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