Michael Quentin MD, Presenter: Nothing to Disclose

Lars Schimmoeller MD, Abstract Co-Author: Nothing to Disclose

Christian Arsov MD, Abstract Co-Author: Nothing to Disclose

Frederic Dietzel, Abstract Co-Author: Nothing to Disclose

Gerald Antoch MD, Abstract Co-Author: Speaker, Siemens Medical AG Speaker, Bayer AG Speaker, BTG International Ltd

Dirk Blondin MD, Abstract Co-Author: Nothing to Disclose

Andreas Hiester, Abstract Co-Author: Nothing to Disclose

Erhard Godehardt, Abstract Co-Author: Nothing to Disclose

Robert Rabenalt, Abstract Co-Author: Nothing to Disclose

Peter Albers MD, PhD, Abstract Co-Author: Nothing to Disclose

This study prospectively compares MR-guided in-bore biopsy with the standard systematic TRUS-guided biopsy in biopsy-naÏve men with elevated PSA.

132 biopsy-naÏve men with elevated PSA (>4 ng/ml) were included in this study. After functional multiparametric MRI at 3T, patients were referred to targeted MR-guided in-bore biopsy of prostate lesions (max 3) followed by a standard systematic TRUS-guided biopsy (12 cores). Analysis of detection rates for PCa and significant PCa (>5 mm total cancer length and/or any Gleason pattern >3).

128 patients (age 66.1±8.1 years; median PSA 6.7 ng/ml, lower quartile 4.1 ng/ml, upper quartile 92.9 ng/ml) met all study requirements. The detection rate of both biopsy methods was 53.1% (significant PCa: TRUS 79.4%; MRI 85.3%). 7.8% of clinically significant PCa were missed by the MR-guided in-bore biopsy and 9.4% by the TRUS biopsy. MR-guided in-bore biopsy needed significantly fewer cores (p<0.01) and showed higher percentage of cancer involvement per biopsy core (p<0.01). The combination of both methods showed a detection rate of 60.9% (significant PCa: 82.1%).

In our population, MR-guided in-bore biopsy and systematic TRUS-guided biopsy achieved equally high detection rates in biopsy-naÏve patients with elevated PSA levels. MR-guided in-bore biopsy needed significantly fewer cores and showed a significantly higher percentage of cancer involvement per biopsy core.

In biopsy-naÏve patients with elevated PSA levels the MR-guided in-bore biopsy is a promising approach for prostate cancer diagnosis. This biopsy method enables equal cancer detection rates with fewer biopsy cores compared to the standard systematic transrectal ultrasound-guided biopsy.

Quentin, M, Schimmoeller, L, Arsov, C, Dietzel, F, Antoch, G, Blondin, D, Hiester, A, Godehardt, E, Rabenalt, R, Albers, P, Prostate Cancer Detection in Biopsy-naïve Men: Targeted MR-guided in-bore Biopsy versus Systematic Transrectal Ultrasound Guided Biopsy.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14008813.html