Magnetic resonance imaging (MRI)/ultrasound (US) fusion guided prostate biopsy with an elastic fusion platform: is it useful in the Chinese population?

Abstract

Objective: To compare a new modality ofMRI/US fusion guided prostate biopsywith conventional TRUS biopsy in a Chi-nese cohort.Patients and Methods: From July 2015 toJuly 2016, 94 Chinese men with elevatedserum prostate-specific antigen (PSA) of4–20 ng/mL underwent pre-biopsy MRIprostate. Those with suspicious lesion(s)underwent fusion biopsy (targeted + 12-core template biopsy) using the ArtemisTMfusion platform. The biopsy outcomes werecompared with a matched cohort of 250patients with conventional TRUS guided12-core systematic biopsy.Results: An average of 1.7  1.0 MRIlesions/patient was detected in 81 patients.In 58 patients having lesions of intermedi-ate to high suspicion, the overall cancerdetection rate was significantly higher thanconventional biopsy group (41.4 vs 17.6%,p < 0.0001). Targeted biopsy alonedetected more clinically significant cancers(24.1% vs 10.4%, p = 0.005) and yieldedsignificantly longer mean cancer corelength (5.84.2 mm vs 3.63.1 mm,p = 0.03). Targeted biopsy alone wouldhave avoided diagnosis of 75% (6/8) of theclinically insignificant cancers at theexpense of missing 12.5% (2/16) of theclinically significant cancers. The compli-cation rates were similar between the twogroups.Conclusion: MRI/US fusion guided pros-tate biopsy is promising in improving thediagnostic yield in Chinese men with ele-vated PSA.