Prebiopsy Magnetic Resonance Imaging and Prostate Cancer Detection: Comparison of Random and Targeted Biopsies

No AccessJournal of UrologyAdult Urology1 Feb 2013Prebiopsy Magnetic Resonance Imaging and Prostate Cancer Detection: Comparison of Random and Targeted Biopsies Nicolas Barry Delongchamps, Michaël Peyromaure, Alexandre Schull, Frédéric Beuvon, Naïm Bouazza, Thierry Flam, Marc Zerbib, Naira Muradyan, Paul Legman, and François Cornud Nicolas Barry DelongchampsNicolas Barry Delongchamps Department of Urology, Assistance Publique-Hôpitaux de Paris, Cochin Hospital, Paris, France More articles by this author , Michaël PeyromaureMichaël Peyromaure Department of Urology, Assistance Publique-Hôpitaux de Paris, Cochin Hospital, Paris, France More articles by this author , Alexandre SchullAlexandre Schull Department of Radiology, Assistance Publique-Hôpitaux de Paris, Cochin Hospital, Paris, France More articles by this author , Frédéric BeuvonFrédéric Beuvon Department of Pathology, Assistance Publique-Hôpitaux de Paris, Cochin Hospital, Paris, France More articles by this author , Naïm BouazzaNaïm Bouazza Department of Clinical Research, Assistance Publique-Hôpitaux de Paris, Tarnier Hospital, Paris, France More articles by this author , Thierry FlamThierry Flam Department of Urology, Assistance Publique-Hôpitaux de Paris, Cochin Hospital, Paris, France More articles by this author , Marc ZerbibMarc Zerbib Department of Urology, Assistance Publique-Hôpitaux de Paris, Cochin Hospital, Paris, France More articles by this author , Naira MuradyanNaira Muradyan iCAD, Inc., Nashua, New Hampshire More articles by this author , Paul LegmanPaul Legman Department of Radiology, Assistance Publique-Hôpitaux de Paris, Cochin Hospital, Paris, France More articles by this author , and François CornudFrançois Cornud Department of Radiology, Assistance Publique-Hôpitaux de Paris, Cochin Hospital, Paris, France Paris Descartes University, Sorbonne Paris Cité and Tourville Imaging Centre, Paris, France More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.08.195AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We compared the accuracy of visual targeted biopsies vs computerized transrectal ultrasound-magnetic resonance imaging registration using a rigid (Esaote®, nondeformable) or elastic (Koelis®, deformable) approach. Materials and Methods: A total of 391 consecutive patients with suspected localized prostate cancer were prospectively included in analysis. All patients underwent prostate magnetic resonance imaging, followed by 10 to 12-core random prostate biopsies. When magnetic resonance imaging detected suspicious findings, targeted biopsy was performed, including visual, rigid system and elastic system targeted biopsies in the first 127 patients, the next 131 and the last 133, respectively. Cancer detection rates were assessed by conditional logistic regression. Targeted biopsies alone and random biopsies were further compared for the amount of tissue sampled and microfocal cancer detection, the latter defined as a single core with 5 mm or less of Gleason 6 cancer. Results: Patient characteristics and random biopsy detection rates were similar among the groups. Magnetic resonance imaging detected at least 1 suspicious area in 54 (42%), 78 (59%) and 82 patients (62%) in groups 1, 2 and 3, respectively. The cancer detection rates of rigid and elastic system targeted biopsies were significantly higher than the random biopsy rate (p = 0.0065 and 0.0016, respectively). Visual targeted biopsy did not perform better than random biopsy (p = 0.66). Rigid and elastic system targeted biopsies allowed for decreasing the number of cores and the detection of microfocal cancer, while increasing the detection of high grade cancer. Conclusions: When performed with computerized magnetic resonance imaging-transrectal ultrasound image registration, targeted biopsy alone improved cancer detection over random biopsies, decreased the detection rate of microfocal cancer and increased the detection rate of cancer with a Gleason score of greater than 6. 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Volume 189Issue 2February 2013Page: 493-499Supplementary Materials Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.Keywordsbiopsyprostatic neoplasmsprostateultrasonographymagnetic resonance imagingMetricsAuthor Information Nicolas Barry Delongchamps Department of Urology, Assistance Publique-Hôpitaux de Paris, Cochin Hospital, Paris, France More articles by this author Michaël Peyromaure Department of Urology, Assistance Publique-Hôpitaux de Paris, Cochin Hospital, Paris, France More articles by this author Alexandre Schull Department of Radiology, Assistance Publique-Hôpitaux de Paris, Cochin Hospital, Paris, France More articles by this author Frédéric Beuvon Department of Pathology, Assistance Publique-Hôpitaux de Paris, Cochin Hospital, Paris, France More articles by this author Naïm Bouazza Department of Clinical Research, Assistance Publique-Hôpitaux de Paris, Tarnier Hospital, Paris, France More articles by this author Thierry Flam Department of Urology, Assistance Publique-Hôpitaux de Paris, Cochin Hospital, Paris, France More articles by this author Marc Zerbib Department of Urology, Assistance Publique-Hôpitaux de Paris, Cochin Hospital, Paris, France More articles by this author Naira Muradyan iCAD, Inc., Nashua, New Hampshire More articles by this author Paul Legman Department of Radiology, Assistance Publique-Hôpitaux de Paris, Cochin Hospital, Paris, France More articles by this author François Cornud Department of Radiology, Assistance Publique-Hôpitaux de Paris, Cochin Hospital, Paris, France Paris Descartes University, Sorbonne Paris Cité and Tourville Imaging Centre, Paris, France More articles by this author Expand All Advertisement PDF DownloadLoading ...