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Transperineal In-Bore 3-T MR Imaging-guided Prostate Biopsy: A Prospective Clinical Observational Study

Institution:
1Division of MRI in the Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
2Division of Urology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
3Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
4Department of Radiology, Dana-Farber Cancer Institute, Boston, MA, USA.
5Department of Radiology, Children's Hospital, Harvard Medical School, Boston, MA, USA.
Publication Date:
Jan-2015
Journal:
Radiology
Volume Number:
274
Issue Number:
1
Pages:
170-80
Citation:
Radiology. 2015 Jan;274(1):170-80.
Links:
http://pubs.rsna.org/doi/full/10.1148/radiol.14140221
PubMed ID:
25222067
PMCID:
PMC4334270
Appears in Collections:
Prostate Group, NA-MIC, NCIGT, SLICER, SNR, SPL
Sponsors:
U54 EB005149/EB/NIBIB NIH HHS/United States
P41 RR019703/RR/NCRR NIH HHS/United States
P41 EB015898/EB/NIBIB NIH HHS/United States
U01 CA151261/CA/NCI NIH HHS/United States
R01 CA111288/CA/NCI NIH HHS/United States
P01 CA067165/CA/NCI NIH HHS/United States
Generated Citation:
Penzkofer T., Tuncali K., Fedorov A., Song S-E., Tokuda J., Fennessy F.M., Vangel M.G., Kibel A.S., Mulkern R.V., Wells III W.M., Hata N., Tempany C.M. Transperineal In-Bore 3-T MR Imaging-guided Prostate Biopsy: A Prospective Clinical Observational Study. Radiology. 2015 Jan;274(1):170-80. PMID: 25222067. PMCID: PMC4334270.
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Purpose To determine the detection rate, clinical relevance, Gleason grade, and location of prostate cancer (PCa) diagnosed with and the safety of an in-bore transperineal 3-T magnetic resonance (MR) imaging-guided prostate biopsy in a clinically heterogeneous patient population. Materials and Methods This prospective retrospectively analyzed study was HIPAA compliant and institutional review board approved, and informed consent was obtained. Eighty-seven men (mean age, 66.2 years ± 6.9) underwent multiparametric endorectal prostate MR imaging at 3 T and transperineal MR imaging-guided biopsy. Three subgroups of patients with at least one lesion suspicious for cancer were included: men with no prior PCa diagnosis, men with PCa who were undergoing active surveillance, and men with treated PCa and suspected recurrence. Exclusion criteria were prior prostatectomy and/or contraindication to 3-T MR imaging. The transperineal MR imaging-guided biopsy was performed in a 70-cm wide-bore 3-T device. Overall patient biopsy outcomes, cancer detection rates, Gleason grade, and location for each subgroup were evaluated and statistically compared by using χ2 and one-way analysis of variance followed by Tukey honestly significant difference post hoc comparisons. Results Ninety biopsy procedures were performed with no serious adverse events, with a mean of 3.7 targets sampled per gland. Cancer was detected in 51 (56.7%) men: 48.1% (25 of 52) with no prior PCa, 61.5% (eight of 13) under active surveillance, and 72.0% (18 of 25) in whom recurrence was suspected. Gleason pattern 4 or higher was diagnosed in 78.1% (25 of 32) in the no prior PCa and active surveillance groups. Gleason scores were not assigned in the suspected recurrence group. MR targets located in the anterior prostate had the highest cancer yield (40 of 64, 62.5%) compared with those for the other parts of the prostate (P < .001). Conclusion In-bore 3-T transperineal MR imaging-guided biopsy, with a mean of 3.7 targets per gland, allowed detection of many clinically relevant cancers, many of which were located anteriorly.

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