Magnetic resonance imaging-ultrasound fusion prostate biopsy – a new era of prostate cancer diagnosis

Abstract

Objective:

MRI‐TRUS fusion targeted biopsy (TB) has been available in our centre since 2015. We herein compare MRI‐TRUS fusion prostate biopsy with standard 12‐core systematic biopsy (SB).

Patients and Methods:

Data of Chinese patients undergone prostate biopsy in Queen Mary Hospital from July 2015 to April 2018 were prospectively collected. We investigate the overall and csPCa detection rate of TB + SB and SB.

Results:

382 patients were included in our study. Multi‐parametric MRI (mpMRI) had NPV 100% for patients with PI‐RADS score ≤ 2. The overall cancer detection rate of TB + SB for first‐time biopsy in patients with PI‐RADS 3–5 lesions was 47.4%, significantly higher than 31.8% in SB (p = 0.006). Significance was also observed in repeat biopsy setting (24.7% vs 14.7%, p = 0.047). TB alone would have detected 41.6% less clinically insignificant PCa and missed 13.6% of csPCa.

The receiver operating characteristic (ROC) curve analysis showed that adding mpMRI PI‐RADS grading to other clinical predictors had an area under curve (AUC) of 0.87 (95% CI 0.82–0.92) for prediction of any grade and csPCa.

Conclusions:

MRI‐US fusion biopsy is a promising modality in prostate cancer diagnosis and will benefit patients in both first‐time and repeat biopsy setting.