Flavio Barchetti, Abstract Co-Author: Nothing to Disclose

Chiara Zini, Presenter: Nothing to Disclose

Valerio Forte MD, Abstract Co-Author: Nothing to Disclose

Carlo Cirelli, Abstract Co-Author: Nothing to Disclose

Carlo Catalano MD, Abstract Co-Author: Nothing to Disclose

Valeria Panebianco MD, Abstract Co-Author: Nothing to Disclose

 to validate the role of a multiparametric-MRI (mp-MRI) exam in the diagnostic procedure of patients with cilinically suspicious Prostate Cancer (PCa).

950 patients with PSA > 2.5 ng/mL and negative TRUS were enrolled in the study. They were divided randomly in 2 groups. Group A included 475 patients who underwent a TRUS-guided biopsy with 10 cores sampled. Group B included 474 patients who first underwent an mp-MRI to detect the suspicius focus of PCa and, after that, underwent a TRUS-guided biopsy with 12 cores, 10 of which performed randomly and the other 2 ones were targeted to the index lesion depicted at mp-MRI. Group A patients with negative results at biopsy, underwent an mp-MRI and than a second TRUS-guided biopsy with 12 cores sampled, according to the scheme used in group B patients. Group B patients with or without negative mp-MRI along with negative findings at following guided biopsy, underwent a second TRUS-guided biopsy using a saturation method. 

In group A a PCa was found in 215 patients after the first biopsy. In group B a PCa was found in 417 patients after the first biopsy; in the remaining 58 patients both mp-MRI and TRUS-guided biopsy were negative for PCa. In 215 out of 260 group A patients with no evidence of PCa at first biopsy, a PCa was found in the second biopsy, 15% of which were transitional zone tumours. In 49 out of 58 group B patients with no evidence of PCa at the first biopsy, a PCa with a Gleason score of 6 (3+3) was found.

mp-MRI is highly recommended in patients with suspicious PCa because it is able to detect the index lesion to which target the biopsy, particularly transitional zone lesions which are not sampled during random TRUS-guided biopsy. Mp-MRI is sometimes unable to depict foci of low-grade PCa, suggesting that patients with negative findings on mp-MRI could be scheduled on active surveillance.  

Avoiding delays in PCa diagnosis or avoiding unecessary biopsies

Barchetti, F, Zini, C, Forte, V, Cirelli, C, Catalano, C, Panebianco, V, Multiparametric-MRI as First Line in the Initial Diagnosis of Prostate Cancer.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14015424.html