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01-04-2016 | Original Article

The detection of significant prostate cancer is correlated with the Prostate Imaging Reporting and Data System (PI-RADS) in MRI/transrectal ultrasound fusion biopsy

Authors: Hannes Cash, Andreas Maxeiner, Carsten Stephan, Thomas Fischer, Tahir Durmus, Josephine Holzmann, Patrick Asbach, Matthias Haas, Stefan Hinz, Jörg Neymeyer, Kurt Miller, Karsten Günzel, Carsten Kempkensteffen

Published in: World Journal of Urology | Issue 4/2016

Abstract

Purpose

To evaluate the performance of real-time MRI/ultrasound (MRI/US) fusion-guided targeted biopsy (TB) in men with primary and repeat biopsies and correlate the prostate cancer detection rate (CDR) with the PI-RADS score.

Methods

Analysis included 408 consecutive men with primary and prior negative biopsies who underwent TB and 10-core random biopsy (RB) between January 2012 and January 2015. TB was performed with a real-time MRI/US fusion platform with sensor-based registration. Clinically significant PCa was defined as Gleason score (GS) ≥7 or GS 6 with maximal cancer core length ≥4 mm for TB and according to Epstein criteria for RB.

Results

The overall CDR was 56 % (227/408). The CDR for primary biopsy was 74 % (60/81) and 57 % (67/117), 49 % (62/126), 45 % (38/84) for patients with 1, 2 and ≥3 prior negative biopsies. CDRs correlated with PI-RADS 2/3/4/5 were 16 % (5/32), 26 % (29/113), 62 % (94/152) and 89 % (99/111), respectively. The rates of significant tumors in relation to PI-RADS 2/3/4/5 were 60 % (3/5), 66 % (19/29), 74 % (70/94), 95 % (94/99). In 139 (61 %) cases with radical prostatectomy (RP), the rates of ≥pT3 tumors in correlation with PI-RADS 4 and 5 were 20 % (11/56) and 49 % (32/65). PI-RADS constituted the strongest predictor of significant PCa detection (p < 0.007).

Conclusions

Real-time MRI/US fusion-guided TB combined with RB improved PCa detection in patients with primary and repeat biopsies. The CDR was strongly correlated with a rising PI-RADS score, values of 4 and 5 increasing the detection of clinically significant tumors and leading to a higher histological stage after RP.

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Title: The detection of significant prostate cancer is correlated with the Prostate Imaging Reporting and Data System (PI-RADS) in MRI/transrectal ultrasound fusion biopsy
Authors: Hannes Cash
Andreas Maxeiner
Carsten Stephan
Thomas Fischer
Tahir Durmus
Josephine Holzmann
Patrick Asbach
Matthias Haas
Stefan Hinz
Jörg Neymeyer
Kurt Miller
Karsten Günzel
Carsten Kempkensteffen
Publication date: 01-04-2016
Publisher: Springer Berlin Heidelberg
Published in: World Journal of Urology / Issue 4/2016
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-015-1671-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The detection of significant prostate cancer is correlated with the Prostate Imaging Reporting and Data System (PI-RADS) in MRI/transrectal ultrasound fusion biopsy

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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