Comparative effectiveness of targeted prostate biopsy using magnetic resonance imaging ultrasound fusion software and visual targeting: A prospective study Journal Article


Authors: Lee, D. J.; Recabal, P.; Sjoberg, D. D.; Thong, A.; Lee, J. K.; Eastham, J. A.; Scardino, P. T.; Vargas, H. A.; Coleman, J.; Ehdaie, B.
Article Title: Comparative effectiveness of targeted prostate biopsy using magnetic resonance imaging ultrasound fusion software and visual targeting: A prospective study
Abstract: Purpose We compared the diagnostic outcomes of magnetic resonance-ultrasound fusion and visually targeted biopsy for targeting regions of interest on prostate multiparametric magnetic resonance imaging. Materials and Methods Patients presenting for prostate biopsy with regions of interest on multiparametric magnetic resonance imaging underwent magnetic resonance imaging targeted biopsy. For each region of interest 2 visually targeted cores were obtained, followed by 2 cores using a magnetic resonance-ultrasound fusion device. Our primary end point was the difference in the detection of high grade (Gleason 7 or greater) and any grade cancer between visually targeted and magnetic resonance-ultrasound fusion, investigated using McNemar's method. Secondary end points were the difference in detection rate by biopsy location using a logistic regression model and the difference in median cancer length using the Wilcoxon signed rank test. Results We identified 396 regions of interest in 286 men. The difference in the detection of high grade cancer between magnetic resonance-ultrasound fusion biopsy and visually targeted biopsy was −1.4% (95% CI −6.4 to 3.6, p=0.6) and for any grade cancer the difference was 3.5% (95% CI −1.9 to 8.9, p=0.2). Median cancer length detected by magnetic resonance-ultrasound fusion and visually targeted biopsy was 5.5 vs 5.8 mm, respectively (p=0.8). Magnetic resonance-ultrasound fusion biopsy detected 15% more cancers in the transition zone (p=0.046) and visually targeted biopsy detected 11% more high grade cancer at the prostate base (p=0.005). Only 52% of all high grade cancers were detected by both techniques. Conclusions We found no evidence of a significant difference in the detection of high grade or any grade cancer between visually targeted and magnetic resonance-ultrasound fusion biopsy. However, the performance of each technique varied in specific biopsy locations and the outcomes of both techniques were complementary. Combining visually targeted biopsy and magnetic resonance-ultrasound fusion biopsy may optimize the detection of prostate cancer. © 2016 American Urological Association Education and Research, Inc.
Keywords: magnetic resonance imaging; prostatic neoplasms; image-guided biopsy
Journal Title: Journal of Urology
Volume: 196
Issue: 3
ISSN: 0022-5347
Publisher: Elsevier Science, Inc.  
Date Published: 2016-09-01
Start Page: 697
End Page: 702
Language: English
DOI: 10.1016/j.juro.2016.03.149
PROVIDER: scopus
PMCID: PMC5014662
PUBMED: 27038768
DOI/URL:
Notes: Article -- Export Date: 1 September 2017 -- Source: Scopus
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  1. Jonathan Coleman
    343 Coleman
  2. Peter T Scardino
    671 Scardino
  3. Daniel D. Sjoberg
    234 Sjoberg
  4. Behfar Ehdaie
    174 Ehdaie
  5. James Eastham
    538 Eastham