Multiparametric Magnetic Resonance Imaging and Ultrasound Fusion Biopsy Detect Prostate Cancer in Patients with Prior Negative Transrectal Ultrasound Biopsies

Objectives: To determine if standard biopsy still has a role in the detection of prostate cancer or clinically significant prostate cancer in biopsy-naive patients with positive multiparametric magnetic resonance imaging. Materials and methods: We extracted, from our prospective maintained fusion biopsy database, patients from March 2014 to December 2018. The detection rate of prostate cancer and clinically significant prostate cancer and complication rate were analysed in a cohort of patients who underwent fusion biopsy alone (group A) or fusion biopsy plus standard biopsy (group B). The International Society of Urological Pathology grade group determined on prostate biopsy with the grade group determined on final pathology among patients who underwent radical prostatectomy were compared. Results: Prostate cancer was found in 249/389 (64.01%) and 215/337 (63.8%) patients in groups A and B, respectively ( P=0.98), while the clinically significant prostate cancer detection rate was 57.8% and 55.1% ( P=0.52). No significant differences in complications were found. No differences in the upgrading rate between biopsy and final pathology finding after radical prostatectomy were recorded. Conclusions: In biopsy-naive patients, with suspected prostate cancer and positive multiparametric magnetic resonance imaging the addition of standard biopsy to fusion biopsy did not increase significantly the detection rate of prostate cancer or clinically significant prostate cancer. Moreover, the rate of upgrading of the cancer grade group between biopsy and final pathology was not affected by the addition of standard biopsy. Level of evidence: Not applicable for this multicentre audit.

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Multiparametric magnetic resonance imaging-transrectal ultrasound fusion biopsies increase the rate of cancer detection in populations with a low incidence of prostate cancer

Investigative and Clinical Urology ◽

10.4111/icu.2019.60.3.156 ◽

2019 ◽

Vol 60 (3) ◽

pp. 156 ◽

Cited By ~ 1

Author(s):

Rohit Kaushal ◽

Chandan J. Das ◽

Prabhjot Singh ◽

Prem Nath Dogra ◽

Rajeev Kumar

Keyword(s):

Magnetic Resonance Imaging ◽

Prostate Cancer ◽

Magnetic Resonance ◽

Cancer Detection ◽

Transrectal Ultrasound ◽

Resonance Imaging ◽

Multiparametric Magnetic Resonance Imaging ◽

Low Incidence

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Critical Evaluation of Magnetic Resonance Imaging Targeted, Transrectal Ultrasound Guided Transperineal Fusion Biopsy for Detection of Prostate Cancer

The Journal of Urology ◽

10.1016/j.juro.2013.04.043 ◽

2013 ◽

Vol 190 (4) ◽

pp. 1380-1386 ◽

Cited By ~ 127

Author(s):

Timur H. Kuru ◽

Matthias C. Roethke ◽

Jonas Seidenader ◽

Tobias Simpfendörfer ◽

Silvan Boxler ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Prostate Cancer ◽

Magnetic Resonance ◽

Critical Evaluation ◽

Transrectal Ultrasound ◽

Resonance Imaging ◽

Ultrasound Guided ◽

Fusion Biopsy

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Cost-effectiveness analysis of magnetic resonance imaging-ultrasound fusion biopsy versus systematic transrectal ultrasound-guided biopsy in diagnosing prostate cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.6_suppl.25 ◽

2017 ◽

Vol 35 (6_suppl) ◽

pp. 25-25 ◽

Cited By ~ 1

Author(s):

Matthew Ingham ◽

Matthew Mossanen ◽

Ye Wang ◽

Steven Lee Chang

Keyword(s):

Magnetic Resonance Imaging ◽

Prostate Cancer ◽

Cost Effectiveness ◽

Magnetic Resonance ◽

Health Outcomes ◽

Transrectal Ultrasound ◽

Sensitivity Analyses ◽

Resonance Imaging ◽

Ultrasound Guided ◽

Fusion Biopsy

25 Background: We sought to determine if the reported improved performance of magnetic resonance imaging-ultrasound (MRI-US) fusion biopsy over systematic transrectal ultrasound-guided biopsy (TRUS) in the detection of prostate cancer justifies the added cost of the MR imaging. Methods: A decision-analytic Markov model with a lifetime horizon of 10 years was developed to evaluate diagnostic accuracy, long-term health outcomes, costs, and quality-of-life of two strategies (i.e., TRUS versus MRI-US fusion biopsy [prostate MRI followed potentially by MRI-US fusion biopsy]) as the initial diagnostic test in men with elevated prostate-specific antigen ( > 4 ng/ml) without prior evaluation. Probabilities of clinical events were obtained from published literature. Direct medical costs, including diagnostic and treatment-related costs, were derived from the Premier Hospital Database. Costs were inflated to 2015 US dollars and discounted at an annual rate of 3%. Health outcomes were measured in quality-adjusted life years (QALYs), which were determined based on published literature and expert opinion. We calculated the incremental cost-effectiveness ratio and performed sensitivity analyses to assess uncertainty. Results: The MRI-US fusion biopsy strategy yielded a lower average discounted cost ($5,358 versus $6,372) and higher total QALYs-gained (7.21 versus 7.19) than TRUS. The reduced expenditures associated with MRI-US fusion biopsy was primarily due to avoiding intervention for clinically insignificant prostate cancer. The results were robust with the sensitivity analyses. Conclusions: For men in the United States with an elevated PSA, the use of MRI-US fusion biopsy in the evaluation for prostate cancer represents a greater value than TRUS, the standard of care option. Widespread adoption of MRI-US fusion biopsy may serve to reduce the economic burden of prostate cancer.

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