Multiparametric MRI Fusion-guided Biopsy for the Diagnosis of Prostate Cancer: Results of the First 100 Consecutive Patients

Abstract

Objective: Our aim was to compare prostate cancer detection rates according to International Society of Urological Pathology (ISUP) grade group (GG) among magnetic resonance imaging (MRI)-targeted biopsies (TBx), systematic biopsies (SBx) and a combination of both (TBx + SBx). Materials and Methods: Between July 2018 and Nov 2020, 100 patients undergoing MRI-targeted prostate biopsy and SB were analysed retrospectively. Men with MRI-visible prostate lesions underwent both MRI-targeted (UroNav®) and systematic 12-core biopsy. The primary outcome was cancer detection according to ISUP GG. The secondary outcome were detection of cancers of GG 2 or higher. Results: The overall cancer detection rate in the study was 43%. Among these, a histopathological ISUP grade of 1 was detected in 44.2%, ISUP grade 2 in 32.5% and higher-grade groups in 23.2% of patients. MRI-TB detected 38 and SBx biopsy detected 30 of the overall study cohort. Combined biopsy led to a cancer diagnoses in 18 more men than with either method alone. Significant cancer detection was 53.4% for TBx, 39.5% for SBx, and highest 55.8% for combination TBx + SBx (p=0.038). Most of the cancers missed by SBx were clinically significant. No significant side effects were recorded. The overall cancer detection rate was 20.4%/46.6% and 90.2% for prostate imaging reporting and data system 3/4/5, respectively. Conclusion: Our results have shown that among patients with lesions visible on MRI, combined biopsy led to greater detection of all prostate cancers, providing increased detection of clinically significant tumours