Investigative and Clinical Urology

The Korean Urological Association (대한비뇨의학회)
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Initial experience of magnetic resonance imaging/ultrasonography fusion transperineal biopsy: Biopsy techniques and results for 75 patients

  • Tae, Jong Hyun (Department of Urology, Korea University Medical Center, Korea University School of Medicine) ;
  • Shim, Ji Sung (Department of Urology, Korea University Medical Center, Korea University School of Medicine) ;
  • Jin, Hyun Jung (Department of Urology, Korea University Medical Center, Korea University School of Medicine) ;
  • Yoon, Sung Goo (Department of Urology, Korea University Medical Center, Korea University School of Medicine) ;
  • No, Tae Il (Department of Urology, Korea University Medical Center, Korea University School of Medicine) ;
  • Kim, Jae Yoon (Department of Urology, Korea University Medical Center, Korea University School of Medicine) ;
  • Kang, Seok Ho (Department of Urology, Korea University Medical Center, Korea University School of Medicine) ;
  • Cheon, Jun (Department of Urology, Korea University Medical Center, Korea University School of Medicine) ;
  • Kang, Sung Gu (Department of Urology, Korea University Medical Center, Korea University School of Medicine)
  • Received : 2018.09.26
  • Accepted : 2018.10.19
  • Published : 2018.11.10
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Abstract

Purpose: The aim of this study is to describe the technique and to report early results of transperineal magnetic resonance imaging and ultrasonography (MRI-US) fusion biopsy. Materials and Methods: A total of 75 patients underwent MRI-US fusion transperineal biopsy. Targeted biopsy via MRI-US fusion imaging was carried out for cancer-suspicious lesions with additional systematic biopsy. Detection rates for overall and clinically significant prostate cancer (csPCa) were evaluated and compared between systematic and targeted biopsy. In addition, further investigation into the detection rate according to prostate imaging reporting and data system (PI-RADS) score was done. Results of repeat biopsies were also evaluated. Results: Overall cancer detection rate was 61.3% (46 patients) and the detection rate for csPCa was 42.7% (32 patients). Overall detection rates for systematic and targeted biopsy were 41.3% and 57.3% (p<0.05), respectively. Detection rates for csPCa were 26.7% and 41.3%, respectively (p<0.05). The cancer detection rates via MRI fusion target biopsy were 30.8% in PI-RADS 3, 62.1% in PI-RADS 4 and 89.4% in PI-RADS 5. Rates of csPCa missed by targeted biopsy and systematic biopsy were 0.0% and 25.0%, respectively. The cancer detection rate in repeat biopsies was 61.1% (11 among 18 patients) in which 55.5% of cancer suspected lesions were located in the anterior portion. Conclusions: Transperineal MRI-US fusion biopsy is useful for improving overall cancer detection rate and especially detection of csPCa. Transperineal MRI-US targeted biopsy show potential benefits to improve cancer detection rate in patients with high PIRADS score, tumor located at the anterior portion and in repeat biopsies.

Keywords

Acknowledgement

Supported by : Korea University

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