MRI-guided core needle biopsy of the prostate: acceptance and side effects

Abstract

PURPOSE We aimed to study side effects, complications, and patient acceptance of magnetic resonance imaging-guided real-time biopsy (MRI-GB) of the prostate. METHODSFifty-four men (49-78 years) with elevated prostate-specif-ic antigen after at least one negative systematic transrectal ultrasound-guided biopsy (TRUS-GB) were included in a prospective clinical study. Suspicious areas on images were selectively sampled by obtaining a median of four specimens (range, 1-9 specimens) using MRI-GB. In TRUS-GB, a medi-an of 10 specimens (range, 6-14 specimens) were obtained. Telephone interviews were conducted one week after outpa-tient MRI-GB, asking patients about pain and side effects (he-maturia, hemospermia, rectal bleeding, fever, and chills) of the two biopsy procedures and which of the two procedures they preferred. Multinomial regression analysis and Fisher's exact test was used to test for differences. RESULTSMRI-GB was preferred by 65% (35/54), and 82% (44/54) would undergo MRI-GB again. Pain intensity (P = 0.005) and bleeding duration (P = 0.004) were significantly lower for MRI-GB compared with TRUS-GB. Hematuria was less com-mon after MRI-GB compared with TRUS-GB (P = 0.006). A high correlation was given between bleeding intensity and bleeding duration for TRUS-GB (r=0.77) and pain intensity and pain duration for MRI-GB (r=0.65). Although hemosper-mia, rectal hemorrhage, fever, and chills were less common in MRI, they showed no statistically significant difference. CONCLUSIONMRI-GB of the prostate seems to have fewer side effects and less pain intensity than TRUS-GB and was preferred by the majority of patients.