Magnetic resonance imaging-guided biopsies may improve diagnosis in biopsy-naive men with suspicion of prostate cancer.

Autor:	Winther MD; sfc113@alumni.ku.dk., Balslev I, Boesen L, Logager V, Noergaard N, Thestrup KD, Thomsen HS
Jazyk:	angličtina
Zdroj:	Danish medical journal [Dan Med J] 2017 May; Vol. 64 (5).
Abstrakt:	Introduction: The purpose of this pilot study was to investigate whether a short prostate biparametric magnetic resonance imaging (bp-MRI) protocol provides a valuable diagnostic addition for biopsy guidance in biopsy-naive men with a suspicion of prostate cancer (PCa). Methods: A total of 62 biopsy-naive patients referred to a systematic transrectal ultrasound biopsy (TRUS-bx) due to suspicion of PCa were prospectively enrolled. Bp-MRI was performed before biopsy. All lesions were scored according to the modified Prostate Imaging Reporting and Data System (PI-RADS) version 2. All patients underwent TRUS-bx followed by bp-MRI-guided biopsies (bp-MRI-bx) under MRI/TRUS image fusion from any bp-MRI suspicious lesions not obviously targeted by TRUS-bx. Results: PCa was found in 42 (68%) and 32 (52%) patients by TRUS-bx and bp-MRI-bx, respectively. Bp-MRI-bx de-tected PCa in one patient who had been missed by TRUS-bx, and found the highest Gleason score (GS) in 13 (30%) patients leading to an overall GS upgrade in six (14%) patients. Bp-MRI missed nine patients with GS = 6 and two with a GS = 7 (3 + 4), all of whom were diagnosed by TRUS-bx. Conclusions: Addition of bp-MRI-bx to routine TRUS-bx seems feasible in biopsy-naive patients and may improve the detection of aggressive PCa in first-round biopsies. This pilot study thus provides an incentive for a larger investigation. Funding: Costs were covered by the Department of Radiology, Herlev Hospital, Denmark. Trial Registration: This study was registered with the Danish Data Protection Agency (HEH-2015-054, I-Suite no: 03775) and with the Committee for Health Research Ethics (no. H-15009341). (Articles published in the DMJ are “open access”. This means that the articles are distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits any non-commercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.)
Databáze:	MEDLINE
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