Comparison of detection of significant and insignificant carcinoma using systematic and targeted MRI/TRUS fusion prostate biopsy

Česká verzia

Authors: Miroslav Záleský ^1,4; Jiří Stejskal ¹; Ivo Minárik ³; Markéta Koldová ³; Vanda Adamcová ¹; Jana Votrubová ²; Adam Pavličko ²; Marek Babjuk ³; Roman Zachoval ^1,4,5
Authors place of work: Urologické oddělení, Thomayerova nemocnice, Praha ¹; Radiologické oddělení, Thomayerova nemocnice, Praha ²; Urologická klinika, Fakultní nemocnice Motol, Praha ³; Urologické klinika 1. LF UK, Praha ⁴; Urologické klinika 3. LF UK, Praha ⁵
Published in the journal: Ces Urol 2018; 22(2): 115-121
Category: Original Articles

Summary

Major statement:

Detection of insignificant prostate cancer by systematic biopsy is significantly higher than by targeted MRI fusion biopsy. Targeted biopsy in combination with systematic biopsy reached significantly higher detection rate of clinically significant prostate cancer than systematic biopsy in the rebiopsy group.

Introduction and objectives:

Detection of insignificant cancer is one of the major problems of PSA-based prostate cancer diagnostic algorithm with subsequent systematic prostate biopsy. MRI with targeted fusion biopsy should increase the detection of significant prostate cancer. The aim of this bicentric prospective study was to compare detection rates of clinically significant and insignificant prostate cancer by MRI/ TRUS fusion targeted biopsy (TG) and systematic biopsy (SB). Materials and methods: MRI was performed on 419 patients based on a suspicion of prostate cancer linked to elevated PSA levels. MRI was positive in 385 patients, the first biopsy group (FB) had 211 and rebiopsy group (RB) had 174 patients. A subsequent TG, followed by a SB was performed on these patients.

Results:

In detection of significant prostate cancer a statically significant difference was reached for TG+SB against SB in rebiopsy group – 35.1 % vs. 25.3 %, p = 0.047. In detection of insignificant prostate cancer the systematic biopsy had a significantly higher detection rate than targeted in both subgroups (FB and RB) – FB 11.9 % vs. 4.7 %, p = 0.008; RB 13.8 % vs. 6.9 % p = 0,034. Conclusion: Detection of insignificant prostate cancer by systematic biopsy is significantly higher than by targeted MRI fusion biopsy. MRI/TRUS targeted biopsy in combination with systematic biopsy had a significantly higher detection rates than systematic biopsy in the repeated biopsy only.

KEY WORDS

Prostate cancer, diagnostics, MRI, prostate biopsy, fusion.

Zdroje

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