Objective:
In recent years, prostate biopsy under multiparametric magnetic resonance (MPMR) imaging gradually increasing due to inability of transrectal ultrasonography (TRUS) for the detection of suspicious areas about prostate cancer (PC). In this study, we aimed to evaluate the success of MPMRI-guided TRUS cognitive biopsy on the detection of PC.
Materials and Methods:
We evaluated the data of 87 patients who underwent MPMRI-guided TRUS cognitive biopsy due to suspicion of PC [due to ≥2,5 ng/mL prostate specific antigen (PSA) value and/or abnormal digital rectal examination] at Ankara University School of Medicine, Department of Urology, between August 2013 and March 2015. All patients were divided into two groups as positive (51 patients) and negative (36 patients) suspicious area on MPMRI. Data of age, PSA level, DRE findings, previous biopsy history, pathologic results and gleason score (in whom PC was detected) were recorded.
Results:
The mean age, the mean PSA value and the mean prostate volume of our cases were 61±13.1, 6.55±3.64 ng/mL and 52±25 g, respectively. We planned prostate biopsy due to high PSA value in 79 of all cases and suspicious DRM in 8 of all cases. First biopsy was performed in 72 of all cases whereas 15 patients underwent second biopsy. PC was detected in 26 (29.9%) patients. PC determined from suspicious locus on MPMRI in 23 of 26 patients and from only systematic 12 core biopsy in the remaining three cases. Only systematic 12 core biopsies were performed in 36 patients who had any suspicious locus on MPMRI, and PC was detected in none of these patients. Sensitivity, specificity, negative predictive value, positive predictive value and accuracy rate of MPMRI-guided TRUS cognitive biopsy on detection of PC were 100%, 59%, 100%, 51% and 71%, respectively.
Conclusion:
Pre-biopsy MPMRI may be recommended for evaluation of PC in all suspicious cases, especially in patients who were planned re-biopsy for continuing of PC suspicion despite PC was not detected at initial biopsy.
Keywords: Magnetic resonance imaging, prostate biopsy, prostate cancer, transrectal ultrasound