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Critical Evaluation of Magnetic Resonance Imaging Targeted, Transrectal Ultrasound Guided Transperineal Fusion Biopsy for Detection of Prostate Cancer

2013; Lippincott Williams & Wilkins; Volume: 190; Issue: 4 Linguagem: Inglês

10.1016/j.juro.2013.04.043

1527-3792

Timur H. Kuru, Matthias Roethke, Jonas Seidenader, Tobias Simpfendörfer, Silvan Boxler, Khalid Alammar, Philip Rieker, Valentin I. Popeneciu, Wilfried Roth, Sascha Pahernik, Heinz-Peter Schlemmer, Markus Hohenfellner, Boris Hadaschik,

Bladder and Urothelial Cancer Treatments

No AccessJournal of UrologyPediatric Urology1 Oct 2013Critical Evaluation of Magnetic Resonance Imaging Targeted, Transrectal Ultrasound Guided Transperineal Fusion Biopsy for Detection of Prostate Cancer Timur H. Kuru, Matthias C. Roethke, Jonas Seidenader, Tobias Simpfendörfer, Silvan Boxler, Khalid Alammar, Philip Rieker, Valentin I. Popeneciu, Wilfried Roth, Sascha Pahernik, Heinz-Peter Schlemmer, Markus Hohenfellner, and Boris A. Hadaschik Timur H. KuruTimur H. Kuru Department of Urology, University Hospital Heidelberg, Heidelberg, Germany Department of Radiology, German Cancer Research Center, Heidelberg, Germany , Matthias C. RoethkeMatthias C. Roethke Department of Radiology, German Cancer Research Center, Heidelberg, Germany , Jonas SeidenaderJonas Seidenader Department of Urology, University Hospital Heidelberg, Heidelberg, Germany , Tobias SimpfendörferTobias Simpfendörfer Department of Urology, University Hospital Heidelberg, Heidelberg, Germany , Silvan BoxlerSilvan Boxler Department of Urology, University Hospital Heidelberg, Heidelberg, Germany , Khalid AlammarKhalid Alammar Department of Urology, University Hospital Heidelberg, Heidelberg, Germany , Philip RiekerPhilip Rieker Department of Urology, University Hospital Heidelberg, Heidelberg, Germany , Valentin I. PopeneciuValentin I. Popeneciu Department of Urology, University Hospital Heidelberg, Heidelberg, Germany , Wilfried RothWilfried Roth Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany , Sascha PahernikSascha Pahernik Department of Urology, University Hospital Heidelberg, Heidelberg, Germany , Heinz-Peter SchlemmerHeinz-Peter Schlemmer Department of Radiology, German Cancer Research Center, Heidelberg, Germany , Markus HohenfellnerMarkus Hohenfellner Department of Urology, University Hospital Heidelberg, Heidelberg, Germany , and Boris A. HadaschikBoris A. Hadaschik Department of Urology, University Hospital Heidelberg, Heidelberg, Germany View All Author Informationhttps://doi.org/10.1016/j.juro.2013.04.043AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Diagnosis and precise risk stratification of prostate cancer is essential for individualized treatment decisions. Magnetic resonance imaging/transrectal ultrasound fusion has shown encouraging results for detecting clinically significant prostate cancer. We critically evaluated magnetic resonance imaging targeted, transrectal ultrasound guided transperineal fusion biopsy in routine clinical practice. Materials and Methods: Included in this prospective study were 347 consecutive patients with findings suspicious for prostate cancer. Median age was 65 years (range 42 to 84) and mean prostate specific antigen was 9.85 ng/ml (range 0.5 to 104). Of the men 49% previously underwent transrectal ultrasound guided biopsies, which were negative, and 51% underwent primary biopsy. In all patients 3 Tesla multiparametric magnetic resonance imaging was done. Systematic stereotactic prostate biopsies plus magnetic resonance imaging targeted, transrectal ultrasound guided biopsies were performed in those with abnormalities on magnetic resonance imaging. Imaging data and biopsy results were analyzed. A self-designed questionnaire was sent to all men on further clinical history and biopsy adverse effects. Results: Of 347 patients biopsy samples of 200 (58%) showed prostate cancer and 73.5% of biopsy proven prostate cancer were clinically relevant according to National Comprehensive Cancer Network (NCCN) criteria. On multiparametric magnetic resonance imaging 104 men had findings highly suspicious for prostate cancer. The tumor detection rate was 82.6% (86 of 104 men) with a Gleason score of 7 or greater in 72%. Overall targeted cores detected significantly more cancer than systematic biopsies (30% vs 8.2%). Of 94 patients without cancer suspicious lesions on magnetic resonance imaging 11 (11.7%) were diagnosed with intermediate risk disease. Regarding adverse effects, 152 of 300 patients (50.6%) reported mild hematuria, 26% had temporary erectile dysfunction and 2.6% needed short-term catheterization after biopsy. Nonseptic febrile urinary tract infections developed in 3 patients (1%). Conclusions: Magnetic resonance imaging targeted, transrectal ultrasound guided transperineal fusion biopsy provides high detection of clinically significant tumors. Since multiparametric magnetic resonance imaging still has some limitations, systematic biopsies should currently not be omitted. The morbidity of the transperineal saturation approach is reasonable and mainly self-limiting. References 1 : Cancer statistics, 2013. CA Cancer J Clin2013; 63: 11. Google Scholar 2 : Contemporary role of systematic prostate biopsies: indications, techniques, and implications for patient care. Eur Urol2013; 63: 214. Google Scholar 3 : Discrepancy in prostate cancer localization between biopsy and prostatectomy specimens in patients with unilateral positive biopsy: implications for focal therapy. Prostate2012; 72: 1179. 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Google Scholar © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byTaneja S (2018) Re: MRI-Targeted or Standard Biopsy for Prostate-Cancer DiagnosisJournal of Urology, VOL. 200, NO. 4, (697-699), Online publication date: 1-Oct-2018.Prendeville S, Gertner M, Maganti M, Pintilie M, Perlis N, Toi A, Evans A, Finelli A, van der Kwast T and Ghai S (2018) Role of Magnetic Resonance Imaging Targeted Biopsy in Detection of Prostate Cancer Harboring Adverse Pathological Features of Intraductal Carcinoma and Invasive Cribriform CarcinomaJournal of Urology, VOL. 200, NO. 1, (104-113), Online publication date: 1-Jul-2018.Komisarenko M, Wong L, Richard P, Timilshina N, Toi A, Evans A, Zlotta A, Kulkarni G, Hamilton R, Fleshner N and Finelli A (2015) An Increase in Gleason 6 Tumor Volume While on Active Surveillance Portends a Greater Risk of Grade Reclassification with Further FollowupJournal of Urology, VOL. 195, NO. 2, (307-312), Online publication date: 1-Feb-2016.Bryk D, Llukani E, Huang W and Lepor H (2015) Natural History of Pathologically Benign Cancer Suspicious Regions on Multiparametric Magnetic Resonance Imaging Following Targeted BiopsyJournal of Urology, VOL. 194, NO. 5, (1234-1240), Online publication date: 1-Nov-2015.Taneja S (2015) Re: Comparison of MR/Ultrasound Fusion-Guided Biopsy with Ultrasound-Guided Biopsy for the Diagnosis of Prostate CancerJournal of Urology, VOL. 194, NO. 1, (112-115), Online publication date: 1-Jul-2015.Delongchamps N, Lefèvre A, Bouazza N, Beuvon F, Legman P and Cornud F (2014) Detection of Significant Prostate Cancer with Magnetic Resonance Targeted Biopsies—Should Transrectal Ultrasound-Magnetic Resonance Imaging Fusion Guided Biopsies Alone be a Standard of Care?Journal of Urology, VOL. 193, NO. 4, (1198-1204), Online publication date: 1-Apr-2015.Brock M, Löppenberg B, Roghmann F, Pelzer A, Dickmann M, Becker W, Martin-Seidel P, Sommerer F, Schenk L, Palisaar R, Noldus J and von Bodman C (2014) Impact of Real-Time Elastography on Magnetic Resonance Imaging/Ultrasound Fusion Guided Biopsy in Patients with Prior Negative Prostate BiopsiesJournal of Urology, VOL. 193, NO. 4, (1191-1197), Online publication date: 1-Apr-2015.Radtke J, Kuru T, Boxler S, Alt C, Popeneciu I, Huettenbrink C, Klein T, Steinemann S, Bergstraesser C, Roethke M, Roth W, Schlemmer H, Hohenfellner M and Hadaschik B (2014) Comparative Analysis of Transperineal Template Saturation Prostate Biopsy Versus Magnetic Resonance Imaging Targeted Biopsy with Magnetic Resonance Imaging-Ultrasound Fusion GuidanceJournal of Urology, VOL. 193, NO. 1, (87-94), Online publication date: 1-Jan-2015.Crawford E, Rove K, Stone N, Lucia M, Barqawi A and La Rosa F (2014) Moving Forward the State of the Art in Prostate Cancer Treatment: Targeted Focal TherapyUrology Practice, VOL. 1, NO. 3, (156-164), Online publication date: 1-Sep-2014.Bjurlin M, Meng X, Le Nobin J, Wysock J, Lepor H, Rosenkrantz A and Taneja S (2014) Optimization of Prostate Biopsy: the Role of Magnetic Resonance Imaging Targeted Biopsy in Detection, Localization and Risk AssessmentJournal of Urology, VOL. 192, NO. 3, (648-658), Online publication date: 1-Sep-2014.Thompson J, Moses D, Shnier R, Brenner P, Delprado W, Ponsky L, Pulbrook M, Böhm M, Haynes A, Hayen A and Stricker P (2014) Multiparametric Magnetic Resonance Imaging Guided Diagnostic Biopsy Detects Significant Prostate Cancer and could Reduce Unnecessary Biopsies and Over Detection: A Prospective StudyJournal of Urology, VOL. 192, NO. 1, (67-74), Online publication date: 1-Jul-2014.Hadaschik B and Kuru T (2014) Editorial CommentJournal of Urology, VOL. 191, NO. 6, (1754-1754), Online publication date: 1-Jun-2014.Raskolnikov D, Rais-Bahrami S, Turkbey B, Rastinehad A, Choyke P, Wood B and Pinto P (2014) Current Ability of Multiparametric Prostate Magnetic Resonance Imaging and Targeted Biopsy to Improve the Detection of Prostate CancerUrology Practice, VOL. 1, NO. 1, (13-21), Online publication date: 1-May-2014.Taneja S (2014) Re: A Prospective, Blinded Comparison of Magnetic Resonance (MR) Imaging-Ultrasound Fusion and Visual Estimation in the Performance of MR-Targeted Prostate Biopsy: The PROFUS TrialJournal of Urology, VOL. 191, NO. 5, (1287-1287), Online publication date: 1-May-2014. Volume 190Issue 4October 2013Page: 1380-1386Supplementary Materials Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.Keywordstransrectalhigh-intensity focusedultrasoundmagnetic resonance imagingbiopsyprostatic neoplasmsprostateMetricsAuthor Information Timur H. Kuru Department of Urology, University Hospital Heidelberg, Heidelberg, Germany Department of Radiology, German Cancer Research Center, Heidelberg, Germany More articles by this author Matthias C. Roethke Department of Radiology, German Cancer Research Center, Heidelberg, Germany More articles by this author Jonas Seidenader Department of Urology, University Hospital Heidelberg, Heidelberg, Germany More articles by this author Tobias Simpfendörfer Department of Urology, University Hospital Heidelberg, Heidelberg, Germany More articles by this author Silvan Boxler Department of Urology, University Hospital Heidelberg, Heidelberg, Germany More articles by this author Khalid Alammar Department of Urology, University Hospital Heidelberg, Heidelberg, Germany More articles by this author Philip Rieker Department of Urology, University Hospital Heidelberg, Heidelberg, Germany More articles by this author Valentin I. Popeneciu Department of Urology, University Hospital Heidelberg, Heidelberg, Germany More articles by this author Wilfried Roth Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany More articles by this author Sascha Pahernik Department of Urology, University Hospital Heidelberg, Heidelberg, Germany More articles by this author Heinz-Peter Schlemmer Department of Radiology, German Cancer Research Center, Heidelberg, Germany More articles by this author Markus Hohenfellner Department of Urology, University Hospital Heidelberg, Heidelberg, Germany More articles by this author Boris A. Hadaschik Department of Urology, University Hospital Heidelberg, Heidelberg, Germany More articles by this author Expand All Advertisement PDF downloadLoading ...