Sung Il Hwang MD, Presenter: Nothing to Disclose

Hak Jong Lee MD, PhD, Abstract Co-Author: Nothing to Disclose

Chang Jin Yoon, Abstract Co-Author: Nothing to Disclose

To investigate whether MR-US fusion can improve the detection rates of prostate cancer in patients with prior negative prostate biopsy. 

From September 2012 to February 2014, 332 consecutive patients were referred for repeated prostate biopsy to the radiology department. Among them nineteen men (mean age: 62.8±9.2 years) who underwent multiparametric prostate MRI before repeated biopsy were enrolled in the study. Mean PSA was 42.1±103.6 (0.6 ~460). Suspicious areas on MRI were scored for the likelihood of cancer using 5-point index scale, from definite no cancer (score 1) to definite cancer (score 5). MR-US fusion biopsy (Logiq E9, GE) was performed by a single uroradiologist. At least two cores were added at the suspicious area after systematic randomized 12-core biopsy. Addition of two cores after 12-core biopsy was also performed even though there was no delineated suspicious lesion on MRI. Overall detection rate of added biopsy using fusion imaging was compared with that of systematic biopsy. Cancer detection rate in patients with suspicion score over 3 on MRI Mean score of likelihood of cancer on MRI was compared in patients with added core positive for cancer and negative.  

Prostate cancer was detected in 12 out of 19 patients (63.2%). 82 out of 273 cores were positive for cancer (30.0%). Detection rate for added cores was 34.9% (15/43), while 67 out of 230 systematic cores were positive (29.1%). However, for the patients with suspicion score over 3 on MRI (n=12), cancer was detected 11 patients (91.7%). Detection rates for the added cores in this subgroup rises to 57.7% (15/26). Added core showed highest gleason score in 7 out of 11 cancer patients with suspicion score over 3. In one patient with suspicion score 5, cancer was detected only at the added cores, while systematic biopsy failed to detect cancer. 

MR-US fusion showed increased detection rate for the prostate cancer, especially in patients with suspected cancer on prebiopsy MRI.  

Prebiopsy MRI may guide the treatment plan in patients with active surveillance for prostate cancer. And fusion of MRI and US can help to detect cancer precisely, reducing false negative results. 

Hwang, S, Lee, H, Yoon, C, Value of MR-US Fusion in the Guidance of Repeated Prostate Biopsy: Initial Experience.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14013530.html