Multiparametric magnetic resonance imaging/transrectal ultrasound fusion-guided prostate biopsy: a comparison with systematic transrectal ultrasound-guided prostate biopsy

G. Silecchia 1, U. Falagario 1, F. Sanguedolce 2, L. Macarini 3, R. Autorino 4, L. Cormio 1

1 Urology and Renal Transplantation Unit, Department of Medical and Surgical Sciences, University of Foggia, Italy; 2 Section of Pathology; Department of Clinical and Experimental Medicine, University of Foggia, Italy; 3 Department of Radiology, University of Foggia, Italy; 4 Division of Urology, Department of Surgery, VCU Health, Richmond, VA, USA.

Background & Aims. Prostate biopsy is the standard method for diagnosing prostate cancer. Herein we compared the cancer detection rate of extended systematic Transrectal Prostate Biopsy with that of multiparametric Magnetic Resonance Imaging/Transrectal ultrasound fusion-guided Prostate Biopsy.

Methods. Outcomes of 99 fusion prostate biopsy (Group A) were compared with those of a matched population of patients having undergone systematic transrectal prostate biopsy (Group B) in the same period. 

Results. The overall cancer detection rate was 60.6% in Group A and 29,2% in Group B (p = < 0,001) whereas the rate of clinically-significant prostate cancer was 26.2% in Group A and 13,1% in Group B (p = 0,02). At first prostate biopsy the above-mentioned rates were 76% in Group A and 31,9% in Group B (p < 0,001), whereas in repeated biopsy the rates were 34,7% in Group A and 18,6% in Group B (p = 0,08). Cancer detection rates correlated well with the Prostate Imaging-Reporting and Data System; in the setting of first biopsy, it was 84,6, 67,8, 100% for score 3, 4 and 5, respectively, whereas in the setting of repeat biopsy it was 28,5, 55,5 and 80% for score 3, 4 and 5, respectively. Complications rate was similar in both groups but all occurred in patients > 75y.

Conclusions. Multiparametric Magnetic Resonance Imaging/transrectal ultrasound fusion-guided biopsy provided better prostate cancer detection rates than standard Prostate Biopsy in the setting of both first and repeated Prostate Biopsy, showing good correlation between Prostate Imaging-Reporting and Data System scores and cancer detection rates but complications were more common in elderly patients.

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