Multiparametric magnetic resonance imaging-targeted biopsy for the detection of prostate cancer in patients with prior negative biopsy results

作者：Abdi Hamidreza; Zargar Homayoun; Goldenberg S Larry; Walshe Triona; Pourmalek Farshad; Eddy Christopher; Chang Silvia D; Gleave Martin E; Harris Alison C; So Alan I; Machan Lindsay; Black Peter C^*

来源：Urologic Oncology-Seminars and Original Investigations, 2015, 33(4): 165.e1.

DOI：10.1016/j.urolonc.2015.01.004

• Prostate
• Prostatic neoplasms
• Magnetic resonance imaging
• Ultrasonography
• Image-guided biopsy
• Targeted biopsy

Purpose: We aimed to determine the performance of multiparametric magnetic resonance imaging (mpMRI) in the detection of prostate cancer (PCa) in patients with prior negative transrectal ultrasound guided prostate biopsy (TRUS-B) results.
Materials and methods: Between 2010 and 2013, 2,416 men underwent TRUS-B or an mpMRI or both at Vancouver General Hospital. Among these, 283 men had persistent suspicion of PCa despite prior negative.TRUS-B finding. An MRI was obtained in 112, and a lesion (prostate imaging reporting and data system score >= 3) was identified in 88 cases (78%). A subsequent combined MRI-targeted and standard template biopsy was performed in 86 cases. A matching cohort of 86 patients was selected using a one-nearest neighbor method without replacement. The end points were the rate of diagnosis of PCa and significant PCa (sPCa) (Gleason > 6, or >2 cores, or >50% of any core).
Results: MRI-targeted TRUS-B detected PCa and sPCa in 36 (41.9%) and 30 (34.9%) men when compared with 19 (22.1%) and 14 (16.3%), respectively, men without mpMRI (P = 0.005 for both). In 9 cases (10.4%), MRI-targeted TRUS-B detected sPCa that was missed on standard cores. sPCa was present in 6 cases (6.9%) on standard cores but not the targeted cores. Multivariate analysis revealed that prostate imaging reporting and data system score and prostate-specific antigen density > 0.15 ng/ml(2) were statistically significant predictors of significant cancer detection (odds ratio = 14.93, P < 0.001 and odds ratio = 6.19, P = 0.02, respectively).
Conclusion: In patients with prior negative TRUS-B finding, MRI-targeted TRUS-B improves the detection rate of all PCa and sPCa.

• 出版日期2015-4