Objective : To determine the accuracy of targeted prostate biopsy guided by computer-assisted fusion of magnetic resonance imaging (MRI) and ultrasound in single center experience.
Methods : All patients with suspicious of prostate cancer that underwent targeted biopsy using MRI fusion ultrasound guided with transrectal and transperineal approach between September 2017 and January 2018 were reviewed. Data composed of demographic information, preoperative PSA, multiparametric MRI data (PI-RADS version2), perioperative information and histopathological reports.
Result : 39 consecutive patients with suspected prostate cancer underwent prostate biopsy for total 56 lesions. Mean age was 70 years old. Mean preoperative PSA was 16.56 ng/ml. Mean prostate volume was 55.48 ml. Overall detection rate of prostate cancer was 46.42% (26/56) which were transrectal approach 30.76% (4/13) and transperineal approach 51.16% (22/43). Detection rates categorized by PIRADS score 3,4 and 5 were 7%, 48%, and 80% respectively. Per-patient analysis showed better overall detection rate from targeted biopsy rather than random biopsy (56.41% vs 43.59%) In subgroup analysis, patients with previous negative biopsy had more significant cancer (defined as the presence of Gleason pattern 4) than biopsy-naïve patients (OR 3.75, 95%CI 0.50-28.39, p=0.20)
Conclusion : From our study, we found that MRI fusion ultrasound prostate biopsy improve cancer detection rate more than systematic biopsy especially in PIRADS 5. This novel technique detect more significant cancer in patients with previous negative biopsy.