How reliable is a negative MRI/TRUS fusion biopsy? The predictive value of targeted biopsy for prostate cancer.

2015 ◽  
Vol 33 (7_suppl) ◽  
pp. 51-51
Author(s):  
Michele Fascelli ◽  
Rachael Sussman ◽  
Thomas P Frye ◽  
Arvin Koruthu George ◽  
Steven Abboud ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Predictive Value ◽  
Lesion Size ◽  
Targeted Biopsy ◽  
Fusion Biopsy ◽  
Whole Mount ◽  
Clinically Significant ◽  
Targeted Mri ◽  
Suspicious Lesions ◽  
Over Time

51 Background: Multiparametric MRI (mpMRI) has been shown to improve clinically significant prostate cancer (CaP) detection. Targeted biopsy using MRI/transrectal ultrasonography (TRUS) fusion is a novel diagnostic tool. The negative predictive value (NPV) of an MRI/TRUS fusion targeted biopsy of a suspicious lesion on mpMRI was determined. Methods: 30 of 181 men who underwent prostatectomy from 2008-2014 were retrospectively identified and had at least one lesion on mpMRI negative for cancer on MRI/TRUS fusion biopsy. Whole mount pathology specimens, gold standard for CaP detection, were aligned with MRI to assess true histopathology of all identified targets. Lesions negative for CaP on biopsy and not identified as cancer on pathology were considered true negatives (TN). Lesions biopsied negative but later found to possess foci of CaP on whole mount were considered false negatives (FN). Calculations of NPV were then made per biopsy year, MRI suspicion score, and lesion size on MRI. Results: 48 lesions of a total 81 identified on mpMRI were reported negative for CaP in the 30 patients who underwent fusion biopsy. Of these, 37 lesions were found to be truly negative on histopathology, while 11 lesions had CaP foci on whole mount specimen. Overall NPV was 77% (37/48). The NPV increased over time (Table 1), and was as high as 85.7% most recently. Conclusions: This series demonstrated a NPV of 77% for targeted MRI/TRUS fusion biopsy of lesions seen on mpMRI. The increasing NPV trend noted over time may have further applications to assess the learning curve for this diagnostic method. Not surprisingly, NPV is higher for low and moderately suspicious lesions than for highly suspicious lesions. This data may help physicians interpret the clinical implications of a negative fusion biopsy. [Table: see text]

MP48-04 HOW RELIABLE IS A NEGATIVE MRI/TRUS FUSION BIOPSY? THE NEGATIVE PREDICTIVE VALUE OF TARGETED BIOPSY FOR PROSTATE CANCER

2015 ◽  
Vol 193 (4S) ◽  
Author(s):  
Rachael Sussman ◽  
Michele Fascelli ◽  
Thomas Frye ◽  
Arvin George ◽  
Steven Abboud ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Targeted Biopsy ◽  
Fusion Biopsy

scholarly journals Diagnostic accuracy of the Novel 29 MHz micro-ultrasound “ExactVuTM” for the detection of clinically significant prostate cancer: A prospective single institutional study. A step forward in the diagnosis of prostate cancer

2021 ◽  
Vol 93 (2) ◽  
pp. 132-138
Author(s):  
Francesco Chessa ◽  
Riccardo Schiavina ◽  
Amelio Ercolino ◽  
Caterina Gaudiano ◽  
Davide Giusti ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Predictive Value ◽  
Transrectal Ultrasound ◽  
Peripheral Zone ◽  
Risk Identification ◽  
The Novel ◽  
Fusion Biopsy ◽  
Ultrasound System ◽  
Clinically Significant ◽  
Sensitivity Specificity

Introduction and Objective: ExactVuTM is a real-time micro-ultrasound system which provides, according to the Prostate Risk Identification Using Micro-Ultrasound protocol (PRI-MUS), a 300% higher resolution compared to conventional transrectal ultrasound. To evaluate the performance of ExactVuTM in the detection of Clinically significant Prostate Cancer (CsPCa). Materials and methods: Patients with Prostate Cancer diagnosed at fusion biopsy were imaged with ExactVuTM. CsPCa was defined as any Gleason Score ≥ 3+4. ExactVuTM examination was considered as positive when PRI-MUS score was ≥ 3. PRI-MUS scoring system was considered as correct when the fusion biopsy was positive for CsPCa. A transrectal fusion biopsy- proven CsPCa was considered as a gold standard. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and area under the receiver operator characteristic (ROC) curve (AUC) were calculated. Results: 57 patients out of 68 (84%) had a csPCa. PRI-MUS score was correctly assessed in 68% of cases. Regarding the detection of CsPCa, ExactVuTM ’s sensitivity, specificity, PPV, and NPV was 68%, 73%, 93%, and 31%, respectively and the AUC was 0.7 (95% CI 0.5-0-8). For detecting CsPCa in the transition/ anterior zone the sensitivity, specificity, PPV, and NPV was 45%, 66%, 83% and 25% respectively ant the AUC was 0.5 (95% CI 0.2-0.9). Accounting only the CsPCa located in the peripheral zone, sensitivity, specificity, PPV, and NPV raised up to 74%, 75%, 94%, 33%, respectively with AUC 0.75 (95% CI 0.5-0-9). Conclusions: ExactVuTM provides high resolution of the prostatic peripheral zone and could represent a step forward in the detection of CsPCa as a triage tool. Further studies are needed to confirm these promising results.

scholarly journals Optimal PSA Threshold for Obtaining MRI-Fusion Biopsy in Biopsy-Naïve Patients

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Luke L. Wang ◽  
Brandon L. Henslee ◽  
Peter B. Sam ◽  
Chad A. LaGrange ◽  
Shawna L. Boyle
Keyword(s):  
Magnetic Resonance Imaging ◽  
Prostate Cancer ◽  
Magnetic Resonance ◽  
Prostate Specific Antigen ◽  
Cancer Detection ◽  
Specific Antigen ◽  
Targeted Biopsy ◽  
Resonance Imaging ◽  
Fusion Biopsy ◽  
Clinically Significant

Objective. The study investigates the prostate-specific antigen threshold for adding targeted, software-based, magnetic resonance imaging-ultrasound fusion biopsy during a standard 12-core biopsy in biopsy-naïve patients. It secondarily explores whether the targeted biopsy is necessary in setting of abnormal digital rectal examination. Methods. 260 patients with suspected localized prostate cancer with no prior biopsy underwent prostate magnetic resonance imaging and were found to have Prostate Imaging Reporting and Data System score ≥   3 lesion(s). All 260 patients underwent standard 12-core biopsy and targeted biopsy during the same session. Clinically significant cancer was Gleason ≥ 3 + 4. Results. Percentages of patients with prostate-specific antigen 0–1.99, 2–3.99, 4–4.99, 5–5.99, 6–9.99, and ≥ 10 were 3.0%, 4.7%, 20.8%, 16.9%, 37.7%, and 16.9%, respectively. Cumulative frequency of clinically significant prostate cancer increased with the addition of targeted biopsy compared with standard biopsy alone across all prostate-specific antigen ranges. The difference in clinically significant cancer detection between targeted plus standard biopsy compared to standard biopsy alone becomes statistically significant at prostate-specific antigen >4.3 ( p = 0.031 ). At this threshold, combination biopsy detected 20 clinically significant prostate cancers, while standard detected 14 with 88% sensitivity and 20% specificity. Excluding targeted biopsy in setting of a positive digital rectal exam would save 12.3% magnetic resonance imaging and miss 1.8% clinically significant cancers in our cohort. Conclusions. In biopsy-naïve patients, at prostate-specific antigen >4.3, there is a significant increase in clinically significant prostate cancer detection when targeted biopsy is added to standard biopsy. Obtaining standard biopsy alone in patients with abnormal digital rectal examinations would miss 1.8% clinically significant cancers in our cohort.

scholarly journals MRI-derived PRECISE scores for predicting pathologically-confirmed radiological progression in prostate cancer patients on active surveillance

2020 ◽  
Author(s):  
Iztok Caglic ◽  
Nikita Sushentsev ◽  
Vincent J. Gnanapragasam ◽  
Evis Sala ◽  
Nadeem Shaida ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Active Surveillance ◽  
Predictive Value ◽  
Scoring System ◽  
Lesion Size ◽  
Receiver Operating Curve ◽  
Close Monitoring ◽  
Targeted Mri ◽  
Sensitivity Specificity

Abstract Objectives To assess the predictive value and correlation to pathological progression of the Prostate Cancer Radiological Estimation of Change in Sequential Evaluation (PRECISE) scoring system in the follow-up of prostate cancer (PCa) patients on active surveillance (AS). Methods A total of 295 men enrolled on an AS programme between 2011 and 2018 were included. Baseline multiparametric magnetic resonance imaging (mpMRI) was performed at AS entry to guide biopsy. The follow-up mpMRI studies were prospectively reported by two sub-specialist uroradiologists with 10 years and 13 years of experience. PRECISE scores were dichotomized at the cut-off value of 4, and the sensitivity, specificity, positive predictive value and negative predictive value were calculated. Diagnostic performance was further quantified by using area under the receiver operating curve (AUC) which was based on the results of targeted MRI-US fusion biopsy. Univariate analysis using Cox regression was performed to assess which baseline clinical and mpMRI parameters were related to disease progression on AS. Results Progression rate of the cohort was 13.9% (41/295) over a median follow-up of 52 months. With a cut-off value of category ≥ 4, the PRECISE scoring system showed sensitivity, specificity, PPV and NPV for predicting progression on AS of 0.76, 0.89, 0.52 and 0.96, respectively. The AUC was 0.82 (95% CI = 0.74–0.90). Prostate-specific antigen density (PSA-D), Likert lesion score and index lesion size were the only significant baseline predictors of progression (each p < 0.05). Conclusion The PRECISE scoring system showed good overall performance, and the high NPV may help limit the number of follow-up biopsies required in patients on AS. Key Points • PRECISE scores 1–3 have high NPV which could reduce the need for re-biopsy during active surveillance. • PRECISE scores 4–5 have moderate PPV and should trigger either close monitoring or re-biopsy. • Three baseline predictors (PSA density, lesion size and Likert score) have a significant impact on the progression-free survival (PFS) time.

scholarly journals Cognitive mpMRI/TRUS biopsy of the prostate with using strain elastography

2019 ◽  
pp. 100-108
Author(s):  
A. V. Vasilev ◽  
A. V. Mishchenko ◽  
R. A. Kadyrleev ◽  
A. S. Petrova ◽  
A. K. Nosov ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
False Positive ◽  
Detection Rate ◽  
Peripheral Zone ◽  
Additional Parameter ◽  
Gleason Grade ◽  
Targeted Biopsy ◽  
Fusion Biopsy ◽  
Clinically Significant ◽  
Systematic Biopsy

Purpose. To evaluate the effectiveness of prostate cancer detection with method of cognitive mpMRI/TRUS fusion biopsy using strain sonoelastography.Materials and methods. Cognitive transrectal fusion biopsy of prostate was performed in 32 patients. According to the data of a preliminary conducted mpMRI, 33 foci suspicious of prostate cancer were included (PIRADSv2 = 3–5). Before the biopsy, all patients underwent ultrasound planning using compression sonoelastography.Results. The overall sensitivity was 76% for the targeted biopsy, and 49% for systematic biopsy. The number of biopsy specimens with a clinically significant Gleason grade in the targeted biopsy group was 85% of all columns with cancer specimens, in the systematic biopsy group this number was 68%. On average, the Gleason grade after targeted biopsy was 7.5 ± 0.9, and it was 7.2 ± 0.9 in the columns after systematic biopsy. On average, the percentage of tumor in the columns after targeted biopsy was 72% ± 29% and it was 55% ± 35% in the columns after systematic biopsy. The false positive for mpMRI was 15%. The overall sensitivity for the strain sonoelastography was 69% in this study, clinically significant cancer was detected in 71% of all columns with cancer specimens. False positive for elastography was observed in 18% of cases.Conclusion. Comparing with systematic biopsy, cognitive mpMRI / TRUS fusion biopsy can improve the detection rate of clinically significant prostate cancer and reduce the number of detected cases of clinically insignificant cancer. In cases of a total or subtotal tumor lesion in the peripheral zone detected on mpMRI, it is possible to take fewer columns for morphological verification of the tumor. The use of compression sonoelastography as an additional parameter of navigation in cognitive mpMRI/TRUS fusion biopsy can be considered as a promising way to increase the detection rate of clinically significant prostate cancer.

Using MRI/ultrasound fusion biopsy to detect clinically significant prostate cancer in the African American population.

2014 ◽  
Vol 32 (4_suppl) ◽  
pp. 57-57
Author(s):  
Arvin George ◽  
Soroush Rais-Bahrami ◽  
Jason Rothwax ◽  
Minhaj Siddiqui ◽  
Lambros Stamatakis ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
African American ◽  
Diagnostic Yield ◽  
White Men ◽  
Matched Cohort ◽  
Fusion Biopsy ◽  
Significant Difference ◽  
Clinically Significant ◽  
Student’S T ◽  
Targeted Mri

57 Background: African-American (AA) men are at greater risk for prostate cancer (CaP) and experience increased prostate cancer-specific mortality. We aimed to determine racial disparities in CaP incidence, pathology, and anatomy identified on MRI/US fusion biopsy. Methods: Patients who underwent MP-MRI with targeted MRI/US fusion biopsy at our institution between May 2007 and June 2013 were reviewed. AA patients undergoing fusion biopsy were matched by age and PSA with a Caucasian cohort at a 1:2 ratio. MRI and pathologic parameters including lesion location, number of lesions, and Gleason score. Bivariate comparisons were made with the Student’s t-test and Χ2 analysis. Results: 822 patients had MRI/US fusion biopsy. 127 AA men were paired with a matched cohort of 254 Caucasians. Mean age was 60.2 and 61.4 years and mean PSA was 11.6 and 10.7ng/ml in AAs and Caucasians, respectively. We identified significantly more AA with CaP (49.6% vs 37.4%, p=0.03; Table). AAs also had higher grade disease (Gleason 7-10) versus white men (20.5% vs. 11.8%, p=0.04). Additionally, the diagnostic yield for the AA cohort was significantly higher per sampled lesion (37.5% vs 24.5%, p<0.01), despite no significant differences in % core involvement of the highest risk lesion between the groups. While there was no significant difference in presence of anterior lesions between the groups (15.7% vs 12.9%, p=NS), anterior lesions equally represented the highest risk lesions in both cohorts. Conclusions: MRI/US Fusion-guided biopsy demonstrates increased diagonostic yield/incidence of CaP and higher risk disease in the AA population in an age and PSA matched cohort of Caucasian patients. [Table: see text]

MRI-US fusion targeted biopsy results in men with a history of prior cancer.

2016 ◽  
Vol 34 (2_suppl) ◽  
pp. 88-88
Author(s):  
Cayce Nawaf ◽  
James Rosoff ◽  
Amanda Lu ◽  
Jeffrey Weinreb ◽  
Peter Humphrey ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Active Surveillance ◽  
Prostate Biopsy ◽  
Core Biopsy ◽  
Test Results ◽  
Targeted Biopsy ◽  
Fusion Biopsy ◽  
Chi Square ◽  
History Of ◽  
Clinically Significant

88 Background: Appropriate risk stratification of men on active surveillance for prostate cancer is essential to identify men in whom it is safe to take this deferred treatment approach. This study evaluates upstaging rates using MRI-US fusion targeted biopsy in men who have had a prior positive standard 12-core biopsy. Methods: Between 12/2012 and 06/2015, 374 men with an indication for prostate biopsy underwent pre-biopsy mpMRI followed by 12-core standard trans-rectal mapping biopsy (Mbx) and MRI-Ultrasound fusion targeted biopsy (Tbx) of lesions identified on mpMRI. The combination of Mbx and Tbx, when both occurred, constitutes a fusion biopsy (Fbx). Men who underwent both Mbx with or without Tbx using the Artemis/Pro-Fuse system with a previous non-MRI-guided biopsy and a diagnosis of prior Gleason 6 prostate cancer were included. Patients without a lesion on MRI underwent Mbx only. Maximum Gleason scores (GS) were assigned on a per patient basis with Mbx GS available for all patients in the cohort and Tbx GS available only for patients with a lesion visible on MP-MRI. Clinically significant (CS) cancer was defined as GS ≥ 3+4. GS per patient was compared by chi-square and McNemar’s test. Results: 118 patients met inclusion criteria (Mean PSA = 6.9, Mean age = 62.5). 40 patients (34%) were upstaged by Fbx to Gleason ≥ 7. Of those upstaged, 17 men (14%) would have been missed by Mbx alone, in comparison to 7 (6%) that were missed by Tbx alone. Total number of prior biopsies (p = 0.28) and number of years on Active Surveillance (p = 0.22) were not related to upgrade on Fbx. Older men (65.3 vs. 60.9, p = 0.033) and those with higher PSA (8.7 vs 5.8, p = 0.002) were more likely to be upgraded on Fbx. Tbx was more likely to identify CS cancer than Mbx (85% vs 56%; p < 0.012). Conclusions: MP-MRI Fusion biopsy more accurately stratifies men with a previous prostate biopsy than those receiving a template mapping 12-core biopsy alone. Tbx should be strongly considered before enrolling a patient in active surveillance since up 14% of clinically significant cancer would have been missed with a 12-core biopsy alone. [Table: see text]

Does size matter? Lesion size as an indicator of number of cores needed to detect clinically significant prostate cancer.

2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 283-283
Author(s):  
Amir H. Lebastchi ◽  
Luke P. O'Connor ◽  
Alex Z. Wang ◽  
Nitin Yerram ◽  
Sandeep Gurram ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Prostate Biopsy ◽  
Lesion Size ◽  
Time Interval ◽  
Targeted Biopsy ◽  
Biopsy Core ◽  
Multiple Cores ◽  
Clinically Significant ◽  
Size Matter ◽  
Continuous Predictor

283 Background: MRI/US fusion guided prostate biopsy (FBx) has been shown to detect clinically significant prostate cancer (csCaP) at higher rates and with fewer cores than standard prostate biopsy. Size plays an important role in assigning a suspicion level (PI-RADS) to lesions identified on MRI. However, tumor characteristics may pose challenges to accurately characterizing the lesion despite the size. This study sought to determine if there are size cutoffs at which a lesion may be accurately characterized as clinically significant cancer with a single biopsy core. Methods: A retrospective analysis of a prospectively maintained database of all patients undergoing FBx at an academic referral center between May 2014 and January 2018 was conducted. At least two FBx cores were taken from each lesion identified on mpMRI. GEE-based univariate logistic regression model with exchangeable correlation was used determine if size was a significant predictor of positive and negative agreement. Predictability of size as a significant continuous predictor was quantified by AUC. Size thresholds at which multiple cores per lesion are needed to avoid missing > 2% of csCaP were calculated, allowing for a 25% discordance rate. Results: An analysis of a total of 1141 FBx of 2200 lesions was performed during the study time interval. Size was a significant predictor of both positive (OR = 2.43, 1.83-3.23, p < 0.01) and negative (OR = 0.58, 0.44-0.76, p < 0.01) agreement of csCaP. AUC% for positive and negative agreement was 65.8 and 57.6, respectively. Size thresholds of 0.65 and 1.70 cm limited CS cancers missed by skipping a second targeted biopsy core to 2% while allowing for a 25% discordance. Conclusions: These data indicate that clinically significant prostate cancer in lesions less than 0.65 cm and greater than 1.70 cm may be characterized with a single targeted biopsy core, sparing 33.5% of lesions (21% patients) a double core targeted biopsy.

The performance of targeted magnetic resonance imaging/ultrasound fusion biopsy versus random 12-core biopsy for prediction of total prostate cancer tumor volume.

2014 ◽  
Vol 32 (4_suppl) ◽  
pp. 34-34
Author(s):  
Chinonyerem Okoro ◽  
Soroush Rais-Bahrami ◽  
Arvin George ◽  
Annerleim Walton-Diaz ◽  
Minhaj Siddiqui ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Burden Of Disease ◽  
Core Biopsy ◽  
Tumor Volume ◽  
Poor Correlation ◽  
Targeted Biopsy ◽  
Fusion Biopsy ◽  
Tumor Length ◽  
Total Tumor Volume ◽  
Targeted Mri

34 Background: Tumor quantification with percent core and/or core length involvement is a parameter used to determine burden of disease for patients with prostate cancer (PCa). However, controversy exists regarding tumor quantification in random 12-core biopsies due to discrepancies in lesion targeting and overall needle core lengths obtained. Targeted MRI/US fusion biopsy allows for more optimal lesion targeting and interpretation of this parameter. We aim to correlate highest percentage core involvement and corresponding tumor length for both targeted fusion and random 12-core biopsies with total tumor volume. Methods: Patients who underwent multiparametric MRI (MP-MRI) with targeted MRI/US fusion biopsy at our institution between 2007 and 2012 were reviewed. Those that met Johns Hopkins criteria for active surveillance (AS) based on outside 12−core biopsy were then identified. MRI tumor volumes were calculated in fusion biopsy positive lesions and correlated with the highest percentage core involvement and corresponding tumor length for both targeted fusion biopsy and 12-core biopsy. Bivariate analysis was used to determine the empirical relationship between these variables. Results: Six hundred ninety six patients had MP-MRI with MRI/US fusion biopsy, 109 of which met Johns Hopkins criteria for AS upon entry and 47 of these patients had fusion biopsy confirmed PCa. Mean age was 61 and mean PSA was 5.6ng/ml. For highest percentage core involvement, targeted biopsy showed a positive correlation (r=0.57) whereas 12-core biopsy showed a poor correlation (r=0.016) with the total tumor volume (p<0.0001 and p=0.91 respectively). Similarly, for tumor length of the highest percentage core, targeted biopsy showed a positive correlation (r=0.6) whereas 12-core biopsy showed a poor correlation (r=0.01) with the total tumor volume (p<0.0001 and p=0.94 respectively). Conclusions: Highest percentage core involvement and corresponding tumor length on targeted MRI/US fusion biopsy positively correlate with total tumor volume. Targeted biopsy better predicts overall burden of disease and can aid in risk stratification of patients seeking AS.

Role of core location in targeted MRI-ultrasound fusion biopsy of prostate lesions.

2018 ◽  
Vol 36 (6_suppl) ◽  
pp. 136-136
Author(s):  
Amanda Lu ◽  
Kamyar Ghabili ◽  
Kevin Nguyen ◽  
Preston Sprenkle
Keyword(s):  
Prostate Cancer ◽  
Cancer Detection ◽  
High Volume ◽  
Central Core ◽  
Lesion Volume ◽  
Fusion Biopsy ◽  
Detection Rates ◽  
Clinically Significant ◽  
Targeted Mri

136 Background: Targeted mpMRI fusion biopsy has gained adoption with superior clinically significant cancer detection rates and accuracy over template biopsy. We sought to establish the role of biopsy location within a prostate lesion to detect clinically significant prostate cancer. Methods: From Nov 2016-Aug 2017, 110 patients with positive multiparametric-MRI (mpMRI) underwent targeted and systematic MRI-US fusion biopsy at our institution for clinical suspicion or known history of prostate cancer. Lesions were scored by Prostate imaging reporting and data system (PI-RADS) classification schema by experienced genitourinary radiologists. Biopsy was performed by an oncology-trained urologist (PS) performing a high volume of fusion biopsies. 5 cores were taken from each lesion, each corresponding to a predetermined location (central, medial, lateral, apex, and base of the lesion). Cancer detection rates (CDR) were calculated on a per lesion basis from biopsy histology. Results: 154 prostate lesions were identified and biopsied with an average volume of 1.31 mL. Detection of clinically significant cancer (G>3+4) did not differ significantly among the 5 locations (Table 1). The central core detected slightly more G≥3+4 cancers than the apex core. No concordance of pathology grade was found between the central core and location of the peripheral core (medial, lateral, apex, or base). In 32% (50/154) of lesions, the peripheral cores had a higher Gleason score than the central core. Biopsy of only the central core missed 40% (21/52) of G≥3+4 cancers and 17% (4/24) of G>3+4 cancers. Lesions with higher PIRADs score were more likely to detect cancer in both the central and peripheral cores, but lesion volume was not a significant predictor. Conclusions: Location of biopsy cores within mpMRI-identified prostate lesions has little correlation with detection of clinically significant cancer. However, targeted biopsy of only the center of a lesion can miss 17% of Gleason >3+4 cancers. [Table: see text]

Sign in / Sign up

Export Citation Format

Share Document