MRI-targeted biopsies versus systematic transrectal ultrasound guided biopsies for the diagnosis of localized prostate cancer in biopsy naïve men

Alexandre Peltier, Fouad Aoun, Marc Lemort, Félix Kwizera, Marianne Paesmans, Roland Van Velthoven, Alexandre Peltier, Fouad Aoun, Marc Lemort, Félix Kwizera, Marianne Paesmans, Roland Van Velthoven

Abstract

Introduction: To compare, in the same cohort of men, the detection of clinically significant disease in standard (STD) cores versus multiparametric magnetic resonance imaging (mpMRI) targeted (TAR) cores.

Material and methods: A prospective study was conducted on 129 biopsy naïve men with clinical suspicion of prostate cancer. These patients underwent prebiopsy mpMRI with STD systematic biopsies and TAR biopsies when lesions were found. The agreement between the TAR and the STD protocols was measured using Cohen's kappa coefficient.

Results: Cancer detection rate of MRI-targeted biopsy was 62.7%. TAR protocol demonstrated higher detection rate of clinically significant disease compared to STD protocol. The proportion of cores positive for clinically significant cancer in TAR cores was 28.9% versus 9.8% for STD cores (P < 0.001). The proportion of men with clinically significant cancer and the proportion of men with Gleason score 7 were higher with the TAR protocol than with the STD protocol (P = 0.003; P = 0.0008, resp.).

Conclusion: mpMRI improved clinically significant prostate cancer detection rate compared to STD protocol alone with less tissue sampling and higher Gleason score. Further development in imaging as well as multicentre studies using the START recommendation is needed to elucidate the role of mpMRI targeted biopsy in the management of prostate cancer.

References

    1. Ferlay J., Shin H. R., Bray F., et al. GLOBOCAN 2008: Cancer Incidence and Mortality Worldwide. Lyon, France: International Agency for Research on Cancer; 2010. (IARC Cancer Base No. 10).
    1. Heidenreich A., Abrahamsson P.-A., Artibani W., et al. Early detection of prostate cancer: European association of urology recommendation. European Urology. 2013;64(3):347–354. doi: 10.1016/j.eururo.2013.06.051.
    1. Schroder F. H., van der M. P., Beemsterboer P., et al. Evaluation of the digital rectal examination as a screening test for prostate cancer. Rotterdam section of the European Randomized Study of Screening for Prostate Cancer. Journal of the National Cancer Institute. 1998;90(23):1817–1823.
    1. Schröder F. H., Carter H. B., Wolters T., et al. Early detection of prostate cancer in 2007: part 1: PSA and PSA kinetics. European Urology. 2008;53(3):468–477. doi: 10.1016/j.eururo.2007.10.047.
    1. Djavan B., Ravery V., Zlotta A., et al. Prospective evaluation of prostate cancer detected on biopsies 1, 2, 3 and 4: when should we stop? The Journal of Urology. 2001;166(5):1679–1683. doi: 10.1016/s0022-5347(05)65652-2.
    1. Ahmed H. U., Kirkham A., Arya M., et al. Is it time to consider a role for MRI before prostate biopsy? Nature Reviews Clinical Oncology. 2009;6(4):197–206. doi: 10.1038/nrclinonc.2009.18.
    1. Isebaert S., van den Bergh L., Haustermans K., et al. Multiparametric MRI for prostate cancer localization in correlation to whole-mount histopathology. Journal of Magnetic Resonance Imaging. 2013;37(6):1392–1401. doi: 10.1002/jmri.23938.
    1. Hegde J. V., Mulkern R. V., Panych L. P., et al. Multiparametric MRI of prostate cancer: an update on state-of-the-art techniques and their performance in detecting and localizing prostate cancer. Journal of Magnetic Resonance Imaging. 2013;37(5):1035–1054. doi: 10.1002/jmri.23860.
    1. Ukimura O., Desai M. M., Palmer S., et al. 3-dimensional elastic registration system of prostate biopsy location by real-time 3-dimensional transrectal ultrasound guidance with magnetic resonance/transrectal ultrasound image fusion. The Journal of Urology. 2012;187(3):1080–1086. doi: 10.1016/j.juro.2011.10.124.
    1. Portalez D., Mozer P., Cornud F., et al. Validation of the European Society of Urogenital Radiology scoring system for prostate cancer diagnosis on multiparametric magnetic resonance imaging in a cohort of repeat biopsy patients. European Urology. 2012;62(6):986–996. doi: 10.1016/j.eururo.2012.06.044.
    1. Wysock J. S., Rosenkrantz A. B., Huang W. C., et al. A prospective, blinded comparison of magnetic resonance (MR) imaging-ultrasound fusion and visual estimation in the performance of MR-targeted prostate biopsy: the PROFUS trial. European Urology. 2014;66(2):343–351. doi: 10.1016/j.eururo.2013.10.048.
    1. Moore C. M., Kasivisvanathan V., Eggener S., et al. Standards of reporting for MRI-targeted biopsy studies (START) of the prostate: recommendations from an international working group. European Urology. 2013;64(4):544–552. doi: 10.1016/j.eururo.2013.03.030.
    1. Barentsz J. O., Richenberg J., Clements R., et al. ESUR prostate MR guidelines 2012. European Radiology. 2012;22(4):746–757. doi: 10.1007/s00330-011-2377-y.
    1. Yerram N. K., Volkin D., Turkbey B., et al. Low suspicion lesions on multiparametric magnetic resonance imaging predict for the absence of high-risk prostate cancer. BJU International. 2012;110:E783–E788. doi: 10.1111/j.1464-410x.2012.11646.x.
    1. Gore J. L., Shariat S. F., Miles B. J., et al. Optimal combinations of systematic sextant and laterally directed biopsies for the detection of prostate cancer. Journal of Urology. 2001;165(5):1554–1559. doi: 10.1016/s0022-5347(05)66347-1.
    1. Peltier A., Aoun F., El-Khoury F., et al. 3D versus 2D systematic transrectal ultrasound-guided prostate biopsy: higher cancer detection rate in clinical practice. Prostate Cancer. 2013;2013:5. doi: 10.1155/2013/783243.783243
    1. Bossuyt P. M., Reitsma J. B., Bruns D. E., et al. Towards complete and accurate reporting of studies of diagnostic accuracy:the STARD initiative.Standards for Reporting of Diagnostic Accuracy. Clinical Chemistry. 2003;49(1):1–6. doi: 10.1373/49.1.1.
    1. Moore C. M., Robertson N. L., Arsanious N., et al. Image-guided prostate biopsy using magnetic resonance imaging-derived targets: a systematic review. European Urology. 2013;63(1):125–140. doi: 10.1016/j.eururo.2012.06.004.
    1. Haffner J., Lemaitre L., Puech P., et al. Role of magnetic resonance imaging before initial biopsy: comparison of magnetic resonance imaging-targeted and systematic biopsy for significant prostate cancer detection. BJU International. 2011;108(8B):E171–E178. doi: 10.1111/j.1464-410x.2011.10112.x.
    1. Miyagawa T., Ishikawa S., Kimura T., et al. Real-time virtual sonography for navigation during targeted prostate biopsy using magnetic resonance imaging data. International Journal of Urology. 2010;17(10):855–860. doi: 10.1111/j.1442-2042.2010.02612.x.
    1. Engelhard K., Hollenbach H. P., Kiefer B., Winkel A., Goeb K., Engehausen D. Prostate biopsy in the supine position in a standard 1.5-T scanner under real time MR-imaging control using a MR-compatible endorectal biopsy device. European Radiology. 2006;16(6):1237–1243. doi: 10.1007/s00330-005-0100-6.
    1. Fiard G., Hohn N., Descotes J.-L., Rambeaud J.-J., Troccaz J., Long J.-A. Targeted MRI-guided prostate biopsies for the detection of prostate cancer: initial clinical experience with real-time 3-dimensional transrectal ultrasound guidance and magnetic resonance/transrectal ultrasound image fusion. Urology. 2013;81(6):1372–1378. doi: 10.1016/j.urology.2013.02.022.
    1. Rastinehad A. R., Baccala A. A., Jr., Chung P. H., et al. D'Amico risk stratification correlates with degree of suspicion of prostate cancer on multiparametric magnetic resonance imaging. Journal of Urology. 2011;185(3):815–820. doi: 10.1016/j.juro.2010.10.076.
    1. Park B. K., Lee H. M., Kim C. K., Choi H. Y., Park J. W. Lesion localization in patients with a previous negative transrectal ultrasound biopsy and persistently elevated prostate specific antigen level using diffusion-weighted imaging at three tesla before rebiopsy. Investigative Radiology. 2008;43(11):789–793. doi: 10.1097/RLI.0b013e318183725e.
    1. Mozer P., Rouprêt M., Le Cossec C., et al. First round of targeted biopsies with magnetic resonance imaging/ultrasound-fusion images compared to conventional ultrasound-guided trans-rectal biopsies for the diagnosis of localised prostate cancer. BJU International. 2015;115(1):50–57. doi: 10.1111/bju.12690.
    1. Pokorny M. R., de Rooij M., Duncan E., et al. Prospective study of diagnostic accuracy comparing prostate cancer detection by transrectal ultrasound-guided biopsy versus magnetic resonance (MR) imaging with subsequent MR-guided biopsy in men without previous prostate biopsies. European Urology. 2014;66:22–29. doi: 10.1016/j.eururo.2014.03.002.
    1. Siddiqui M. M., Rais-Bahrami S., Truong H., et al. Magnetic resonance imaging/ultrasound—fusion biopsy significantly upgrades prostate cancer versus systematic 12-core transrectal ultrasound biopsy. European Urology. 2013;64(5):713–719. doi: 10.1016/j.eururo.2013.05.059.
    1. Radtke J. P., Boxler S., Belavarca Y., et al. MP53-09 transitional zone and anterior zone prostate cancer-detection using multiparametric MR-imaging and fusion-guided transperineal biopsy. The Journal of Urology. 2014;191(4, article e592) doi: 10.1016/j.juro.2014.02.1640.

Source: PubMed

Sponsoren und Mitarbeiter

Krankheiten

Drogeninterventionen

3
Abonnieren