To compare the detection rates of prostate cancer in men with PIRADS 3-5 abnormalities on 3T mpMRI using in-bore MRI guided biopsy (MRGB) compared to cognitively directed transperineal biopsy (cTP) and transrectal (cTRUS).
This is a retrospective single centre study of consecutive men attending the private practice clinic of an experienced urologist performing MRGB and an experienced urologist performing cTP and cTRUS biopsy techniques for PIRADS 3-5 lesions identified on 3T mpMRI. SPSS version 22 was used for statistical analysis.
There were 595 target mpMRI lesions from 482 men with PIRADS 3-5 regions of interest during 483 episodes of biopsy. The abnormal mpMRI target lesion was biopsied using the MRGB method for 298 biopsies, cTP method for 248 and by cTRUS for 49 biopsies. There was no significant difference in prostate cancer (CaP) detection between biopsy method in PIRADS 3 (48.9%, 40.0%, 44.4%), PIRADS 4 (73.2%, 81.0%, 85.0%) or PIRADS 5 (95.2, 92.0%, 95.0%) lesions. There was no significant difference in significant CaP detection between biopsy method in PIRADS 3 (42.2%, 30.0%, 33.3%), PIRADS 4 (66.8%, 66.0%, 80.0%) or PIRADS 5 (90.5%, 89.8%, 90.0%) lesions. There was no difference in CaP or significant CaP based on lesion location or size between the methods.
We found no significant difference in the ability to detect CaP or significant CaP using targeted MRGB, cTP, cTRUS methods. Identification of an abnormal area on mpMRI appears more important in increasing the detection of prostate cancer than the technique used to biopsy an MRI abnormality. This article is protected by copyright. All rights reserved.
BJU international. 2017 Jul 27 [Epub ahead of print]
A J Yaxley, J W Yaxley, I Thangasamy, E Ballard, M Pokorny
Prince Charles Hospital Brisbane, Australia., Wesley Hospital Brisbane, Australia., School of Medicine, University of Queensland., QIMR Berghofer Medical Research Institute Queensland, Australia.