Magnetic resonance imaging-guided biopsies may improve diagnosis in biopsy-naive men with suspicion of prostate cancer

Mads Dochedahl Winther, Ingegerd Balslev, Lars Boesen, Vibeke Logager, Nis Noergaard, Karen-Cecilie Duus Thestrup, Henrik S Thomsen

Research output: Contribution to journalJournal articleResearch

7 Citations (Scopus)
172 Downloads (Pure)

Abstract

INTRODUCTION: The purpose of this pilot study was to investigate whether a short prostate biparametric magnetic resonance imaging (bp-MRI) protocol provides a valuable diagnostic addition for biopsy guidance in biopsy-naive men with a suspicion of prostate cancer (PCa).

METHODS: A total of 62 biopsy-naive patients referred to a systematic transrectal ultrasound biopsy (TRUS-bx) due to suspicion of PCa were prospectively enrolled. Bp-MRI was performed before biopsy. All lesions were scored according to the modified Prostate Imaging Reporting and Data System (PI-RADS) version 2. All patients underwent TRUS-bx followed by bp-MRI-guided biopsies (bp-MRI-bx) under MRI/TRUS image fusion from any bp-MRI suspicious lesions not obviously targeted by TRUS-bx.

RESULTS: PCa was found in 42 (68%) and 32 (52%) patients by TRUS-bx and bp-MRI-bx, respectively. Bp-MRI-bx de-tected PCa in one patient who had been missed by TRUS-bx, and found the highest Gleason score (GS) in 13 (30%) patients leading to an overall GS upgrade in six (14%) patients. Bp-MRI missed nine patients with GS = 6 and two with a GS = 7 (3 + 4), all of whom were diagnosed by TRUS-bx.

CONCLUSIONS: Addition of bp-MRI-bx to routine TRUS-bx seems feasible in biopsy-naive patients and may improve the detection of aggressive PCa in first-round biopsies. This pilot study thus provides an incentive for a larger investigation.

FUNDING: Costs were covered by the Department of Radiology, Herlev Hospital, Denmark.

TRIAL REGISTRATION: This study was registered with the Danish Data Protection Agency (HEH-2015-054, I-Suite no: 03775) and with the Committee for Health Research Ethics (no. H-15009341).

Original languageEnglish
Article numberA5355
JournalDanish Medical Journal
Volume64
Issue number5
Number of pages6
ISSN2245-1919
Publication statusPublished - May 2017

Keywords

  • Aged
  • Aged, 80 and over
  • Denmark
  • Humans
  • Image-Guided Biopsy
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Neoplasm Grading
  • Pilot Projects
  • Prostate/pathology
  • Prostate-Specific Antigen/blood
  • Prostatic Neoplasms/diagnosis
  • Ultrasonography

Cite this