PD06-01 SAMPLING OF HYPOECHOIC LESIONS IMPROVES THE PERFORMANCE OF MRI-TARGETED PROSTATE BIOPSY (2016)

You have accessJournal of UrologyImaging/Radiology: Uroradiology II1 Apr 2016PD06-01 SAMPLING OF HYPOECHOIC LESIONS IMPROVES THE PERFORMANCE OF MRI-TARGETED PROSTATE BIOPSY Nabeel Shakir, Minhaj Siddiqui, Arvin George, Michael Kongnyuy, Michele Fascelli, Maria Merino, Baris Turkbey, Peter Choyke, Bradford Wood, and Peter Pinto Nabeel ShakirNabeel Shakir More articles by this author , Minhaj SiddiquiMinhaj Siddiqui More articles by this author , Arvin GeorgeArvin George More articles by this author , Michael KongnyuyMichael Kongnyuy More articles by this author , Michele FascelliMichele Fascelli More articles by this author , Maria MerinoMaria Merino More articles by this author , Baris TurkbeyBaris Turkbey More articles by this author , Peter ChoykePeter Choyke More articles by this author , Bradford WoodBradford Wood More articles by this author , and Peter PintoPeter Pinto More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.2621AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Sampling of hypoechoic ultrasound lesions (HUL) during standard B-mode transrectal ultrasound (TRUS) prostate biopsy is recommended as these areas may harbor prostate cancer (PCa). With the increasing acceptance of MRI-TRUS fusion, the significance of HUL encountered during targeted biopsy is uncertain. The objective of this study was to determine if supplemental biopsy of HUL results in improved cancer detection in men undergoing MRI-TRUS targeted biopsy. METHODS Patients underwent first-time MRI-TRUS targeted biopsy with extended template 12-core TRUS biopsy in the same session as part of a prospective trial from August 2007 to February 2015. Subjects with biopsied HUL were included in this analysis if they were PCa treatment-naive. We compared two biopsy schemes by their corresponding UCSF-CAPRA scores: the first of TRUS plus HUL biopsy, as compared to MRI-TRUS targeted biopsy alone; the second of MRI-TRUS targeted plus HUL biopsy, as compared to TRUS biopsy alone. RESULTS Of 1260 men in the trial, 106 underwent biopsy of 119 HUL. PCa was diagnosed overall in 62/106 men (58%), of whom 39 had intermediate or high risk PCa by CAPRA score. MRI targeted biopsy alone would have misclassified 6/39 cases of intermediate or high risk PCa. The majority of this PCa missed by MRI targeted biopsy alone was detected by HUL biopsy (5/6 cases). In a scheme of MRI targeted plus HUL biopsy rather than MRI targeted alone, only 2 cases of intermediate-risk cancer would have been misclassified, while TRUS biopsy alone would have misclassified 13/39 cases of intermediate or high risk cancer (p=0.005) and TRUS plus HUL biopsy would have misclassified 10/39 cases (p=0.02, Table 1). CONCLUSIONS MRI-TRUS targeted plus HUL biopsy results in increased detection of intermediate and high risk PCa as compared to MRI targeted biopsy alone or standard TRUS with or without HUL biopsy. A dedicated survey of B-mode imaging during TRUS by urologists may aid in identification of HUL and avoid disease misclassification during MRI-TRUS targeted biopsy. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e173-e174 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Nabeel Shakir More articles by this author Minhaj Siddiqui More articles by this author Arvin George More articles by this author Michael Kongnyuy More articles by this author Michele Fascelli More articles by this author Maria Merino More articles by this author Baris Turkbey More articles by this author Peter Choyke More articles by this author Bradford Wood More articles by this author Peter Pinto More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...