Jochen Kruecker PhD, Abstract Co-Author: Employee, Koninklijke Philips Electronics NV

Sheng Xu PhD, Abstract Co-Author: Employee, Koninklijke Philips Electronics NV

Baris Ismail Turkbey MD, Presenter: Nothing to Disclose

Peter L. Choyke MD, Abstract Co-Author: Research agreement, Koninklijke Philips Electronics NV Research agreement, General Electric Company Research agreement, Siemens AG

Peter Pinto, Abstract Co-Author: Nothing to Disclose

Bradford Johns Wood MD, Abstract Co-Author: Support, Koninklijke Philips Electronics NV Support, Celsion Corporation Advisory Board, Koninklijke Philips Electronics NV Support, Biocompatibles International plc, UK Intellectual Property, Koninklijke Philips Electronics NV Intellectual Property, Traxtal, Inc

Pingkun Yan, Abstract Co-Author: Employee, Koninklijke Philips Electronics NV

Julia Locklin MS, Abstract Co-Author: Nothing to Disclose

00030490-DMT et al, Abstract Co-Author: Nothing to Disclose

To describe preliminary clinical results comparing conventional transrectal ultrasound (TRUS)-guided sextant biopsy with TRUS/MRI fusion-guided targeted prostate biopsy

In 65 patients (mean age 62), T2-weighted, dynamic contrast enhanced, diffusion weighted and spectroscopy images of the prostate were obtained with endorectal coil 3T MRI. The images were read by 2 radiologist and lesions suspicious for prostate cancer were assigned a suspicion level (low, moderate, high). Lesion locations were identified on the T2 images and transferred to a system using electromagnetic tracking to fuse T2 images with realtime TRUS for targeted biopsy guidance outside the MRI suite. Both sextant biopsy and TRUS/MRI fusion-targeted biopsy were performed in all patients. The number of positive biopsies by patient and by core were compared for sextant, targeted, and sextant + targeted biopsies

10.4% (85/818) of the sextant biopsy cores and 16.2% (68/420) of the targeted cores were positive for prostate cancer. Cancer was detected in 40% (26/65) of patients by sextant biopsy alone, in 40% (26/65) by targeted biopsy alone, and in 51% (33/65) by combining sextant and targeted biopsy. In the 7 patients with negative sextant and positive targeted biopsy, the mean Gleason score was 6.4 (range 6 to 7). In the 28 patients with only low suspicion lesions, 5.7% and 4.8% of the sextant and targeted cores, respectively, were positive. In the 6 patients with only high suspicion lesions, 16.9% and 59.3% of sextant and targeted cores, respectively, were positive. Mean Gleason scores in all positive sextant and targeted cores were 7.04 and 7.08, respectively. Mean Gleason scores in targeted low, moderate and high suspicion lesions were 6.5, 6.8 and 7.9

TRUS/MRI targeted biopsy can detect significant prostate cancer in patients with negative sextant biopsy. Targeted biopsy results correlate well with MRI suspicion levels. In patients with moderate or high suspicion lesions, targeted biopsy has a significantly higher detection rate per core than sextant biopsy. In select patients, targeted biopsy alone or combined with sextant biopsy may allow detection of prostate cancer after previous failed sextant biopsy  

TRUS/MRI targeted prostate biopsy offers a practical approach to improved cancer detection and potentially to focal therapy guidance in patients with moderate or high-suspicion MRI lesions

Kruecker, J, Xu, S, Turkbey, B, Choyke, P, Pinto, P, Wood, B, Yan, P, Locklin, J, et al, 0, Clinical Experience with Real-Time TRUS/MRI Fusion-guided Targeted Prostate Biopsy.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8012407.html