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01-01-2018 | Urogenital

Incremental diagnostic value of targeted biopsy using mpMRI-TRUS fusion versus 14-fragments prostatic biopsy: a prospective controlled study

Authors: Guilherme C. Mariotti, Priscila M. Falsarella, Rodrigo G. Garcia, Marcos R. G. Queiroz, Gustavo C. Lemos, Ronaldo H. Baroni

Published in: European Radiology | Issue 1/2018

Abstract

Objectives

To compare the incremental diagnostic value of targeted biopsy using real-time multiparametric magnetic resonance imaging and transrectal ultrasound (mpMRI-TRUS) fusion to conventional 14-cores biopsy.

Patients and Methods

Uni-institutional, institutional review board (IRB) approved prospective blinded study comparing TRUS-guided random and targeted biopsy using mpMRI-TRUS fusion, in 100 consecutive men. We included men with clinical-laboratorial suspicious for prostate cancer and Likert score ≥ 3 mp-MRI. Patients previously diagnosed with prostate cancer were excluded. All patients were submitted to 14-cores TRUS-guided biopsy (mpMRI data operator-blinded), followed by targeted biopsy using mpMRI-TRUS fusion.

Results

There was an overall increase in cancer detection rate, from 56% with random technique to 62% combining targeted biopsy using mpMRI-TRUS fusion; incremental diagnosis was even more relevant for clinically significant lesions (Gleason ≥ 7), diagnosing 10% more clinically significant lesions with fusion biopsy technique. Diagnosis upgrade occurred in 5 patients that would have negative results in random biopsies and had clinically significant tumours with the combined technique, and in 5 patients who had the diagnosis of significant tumours after fusion biopsy and clinically insignificant tumours in random biopsies(p=0.0010).

Conclusions

Targeted biopsy using mpMRI-TRUS fusion has incremental diagnostic value in comparison to conventional random biopsy, better detecting clinically significant prostate cancers.

Key Points

• mpMRI-TRUS targeted biopsy increases overall cancer detection rate, but not statistically significant.

• mpMRI-TRUS targeted biopsy actually improves the diagnosis of clinically significant PCa.

• There was no evidence to acquire the mpMRI-TRUS fusion cores alone.

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Title: Incremental diagnostic value of targeted biopsy using mpMRI-TRUS fusion versus 14-fragments prostatic biopsy: a prospective controlled study
Authors: Guilherme C. Mariotti
Priscila M. Falsarella
Rodrigo G. Garcia
Marcos R. G. Queiroz
Gustavo C. Lemos
Ronaldo H. Baroni
Publication date: 01-01-2018
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 1/2018
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-017-4939-0

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Incremental diagnostic value of targeted biopsy using mpMRI-TRUS fusion versus 14-fragments prostatic biopsy: a prospective controlled study

Abstract

Objectives

Patients and Methods

Results

Conclusions

Key Points

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Objectives

Patients and Methods

Results

Conclusions

Key Points

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