MRI-ultrasound fusion-guided prostate biopsy at Péterfy Hospital
DOI: 10.22591/magyurol.2021.3.rafit.9
Authors:
Ráfi Tamás dr.1, Volford Gábor dr.2, Zóber Tamás dr.1, Beöthe Tamás dr.1,
Buzogány István dr.1, Markó Róbert dr.2, Kardos Lilla dr.2, Papp Éva dr.2,Dombovári Péter dr.1
1Péterfy Kórház-Rendelőintézet és Manninger Jenő Országos Traumatológiai Intézet, Urológiai Osztály, Budapest (osztályvezető: Buzogány István dr.)
2Affidea Magyarország Kft. – Péterfy Kórház-Rendelőintézet és Manninger Jenő Országos Traumatológiai Intézet, Budapest
Summary
Introduction: Prostate cancer is the second most common malignancy diagnosed among men globally. The continuous development of magnetic resonance imaging has brought a breakthrough in prostate cancer diagnostics and enabled us to perform novel sampling techniques.
Objective: The aim of our investigation was to summarize our initial results of mpMRI fusion biopsies in order to further improve the detection rate of future sampling.
Materials and Methods: In our Institution between February 2020 and March 2021 TRUS/MRI fusion biopsies were performed on 36 patients using V Nav needle tracking system. The PI-RADS v2 guidance was followed in our MRI reports. PI-RADS score, size, location, extraprostatic extension of the MRI-detected lesions combined with serum PSA levels PSAD and prostate volumes were all investigated to evaluate how they affect the detection rate.
Results: 64% of our patients were diagnosed with histologically confirmed prostate cancer upon fusion biopsy. The detection rate among PI-RADS 5 lesions was 57%, while only 26% among PI-RADS 4 lesions. Malignancy was found at a higher rate among lesions located in transitional zone compared to peripheral zone lesions (56% vs. 33%). The larger axial diameter of the lesions (detected/not detected 20.5 mm vs. 14 mm), higher PSAD values (detected/not detected 0.22 ng/ml2 vs. 0.10 ng/ml2, the presence of extraprostatic extension all increased the detection rates of fusion biopsies. The average prostatic volumes were higher among patients whose biopsy confirmed no malignancy (71 ml vs. 58 ml).
Conclusion: The results of TRUS/MRI fusion biopsies carried out in our Institution are comparable to the International data, although less successful compared to the results reported by other Hungarian research groups. According to our findings the most important factors affecting the detection rate of fusion biopsies are the PI-RADS score, the size, the location, the presence of extraprostatic extension of the lesions coupled with PSAD and prostatic volume. All of the above factors should be taken into consideration in patient selection when indicating fusion biopsies in order to select those who benefit the most of this procedure.