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01-04-2020 | Prostate Cancer | Original Article

One-Stop MRI and MRI/transrectal ultrasound fusion-guided biopsy: an expedited pathway for prostate cancer diagnosis

Authors: Alessandro Tafuri, Akbar N. Ashrafi, Suzanne Palmer, Aliasger Shakir, Giovanni E. Cacciamani, Atsuko Iwata, Tsuyoshi Iwata, Jie Cai, Akash Sali, Chhavi Gupta, Luis G. Medina, Mariana C. Stern, Vinay Duddalwar, Manju Aron, Inderbir S. Gill, Andre Abreu

Published in: World Journal of Urology | Issue 4/2020

Abstract

Purpose

To assess the feasibility, safety, and outcomes of an expedited One-Stop prostate cancer (PCa) diagnostic pathway.

Patients and methods

We identified 370 consecutive patients who underwent multiparametric magnetic resonance imaging (mpMRI) and transrectal ultrasound fusion prostate biopsy (MRI/TRUS-PBx) from our institutional review board-approved database. Patients were divided according to diagnostic pathway: One-Stop (n = 74), with mpMRI and same-day PBx, or Standard (n = 296), with mpMRI followed by a second visit for PBx. mpMRIs were performed and interpreted according to Prostate Imaging-Reporting and Data System (PI-RADS v2). Grade group ≥ 2 PCa defined clinically significant PCa (csPCa). Statistical significance was considered when p < 0.05.

Results

Age (66 vs 66 years, p = 0.59) and PSA density (0.1 vs 0.1 ng/mL², p = 0.26) were not different between One-Stop vs Standard pathway, respectively. One-Stop patients lived further away from the hospital than Standard patients (163 vs 31 km; p < 0.01), and experienced shorter time from mpMRI to PBx (0 vs 7 days; p < 0.01). The number (p = 0.56) and distribution of PI-RADS lesions (p = 0.67) were not different between the groups. All procedures were completed successfully with similar perioperative complications rate (p = 0.24). For patients with PI-RADS 3–5 lesions, the csPCa detection rate (49% vs 41%, p = 0.55) was similar for One-Stop vs Standard, respectively. The negative predictive value of mpMRI (PI-RADS 1–2) for csPCa was 78% for One-Stop vs 83% for Standard (p = 0.99). On multivariate analysis, age, prostate volume and PI-RADS score (p < 0.01), but not diagnostic pathway, predicted csPCa detection.

Conclusion

A One-Stop PCa diagnostic pathway is feasible, safe, and provides similar outcomes in a shorter time compared to the Standard two-visit diagnostic pathway.

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Title: One-Stop MRI and MRI/transrectal ultrasound fusion-guided biopsy: an expedited pathway for prostate cancer diagnosis
Authors: Alessandro Tafuri
Akbar N. Ashrafi
Suzanne Palmer
Aliasger Shakir
Giovanni E. Cacciamani
Atsuko Iwata
Tsuyoshi Iwata
Jie Cai
Akash Sali
Chhavi Gupta
Luis G. Medina
Mariana C. Stern
Vinay Duddalwar
Manju Aron
Inderbir S. Gill
Andre Abreu
Publication date: 01-04-2020
Publisher: Springer Berlin Heidelberg
Keywords: Prostate Cancer
Ultrasound
Prostate Cancer
Ultrasound
Published in: World Journal of Urology / Issue 4/2020
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-019-02835-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

One-Stop MRI and MRI/transrectal ultrasound fusion-guided biopsy: an expedited pathway for prostate cancer diagnosis

Abstract

Purpose

Patients and methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Patients and methods

Results

Conclusion

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