MRI/US fusion prostate biopsy: Our initial experience

  • Vito Lacetera | Vito.Lacetera@gmail.com Azienda Ospedaliera Ospedali Riuniti Marche Nord, Pesaro, Italy.
  • Bernardo Cervelli Azienda Ospedaliera Ospedali Riuniti Marche Nord, Pesaro, Italy.
  • Antonio Cicetti Azienda Ospedaliera Ospedali Riuniti Marche Nord, Pesaro, Italy.
  • Giuliana Gabrielloni Azienda Ospedaliera Ospedali Riuniti Marche Nord, Pesaro, Italy.
  • Michele Montesi Azienda Ospedaliera Ospedali Riuniti Marche Nord, Pesaro, Italy.
  • Roberto Morcellini Azienda Ospedaliera Ospedali Riuniti Marche Nord, Pesaro, Italy.
  • Gianni Parri Azienda Ospedaliera Ospedali Riuniti Marche Nord, Pesaro, Italy.
  • Emilio Recanatini Azienda Ospedaliera Ospedali Riuniti Marche Nord, Pesaro, Italy.
  • Gianluca Giglioni Clinica Urologica, Università Politecnica delle Marche, Azienda Ospedaliera Ospedali Runiti, Ancona, Italy.
  • Andrea Benedetto Galosi Clinica Urologica, Università Politecnica delle Marche, Azienda Ospedaliera Ospedali Runiti, Ancona, Italy.
  • Valerio Beatrici Azienda Ospedaliera Ospedali Riuniti Marche Nord, Pesaro, Italy.

Abstract

Aim: The objective of this study is to present our initial experience with magnetic resonance imaging/ultrasound (MRI/US) fusion biopsy using the Koelis Trinity device after the first consecutive 59 patients. Materials and methods: 59 consecutive patients with suspected prostate cancer (PCA) underwent prostate biopsy using Trinity Koelis® (Koelis, Grenoble, France). We divided the patients into 2 groups: patients with a previous negative mapping underwent to a MRI/US fusion re-biopsy (Group A); and biopsy-naïve patients who underwent to a first stereotactic 3-D mapping of the prostate (Group B). Group A (22 patients):mean age 64 years (CI 48-73), mean PSA = 7.7 ng/ml (CI 4.2- 9.9); mean prostate volume 55 ml(CI 45-82), Digital Rectal Examination (DRE) positive in 2/22, number of lesions detected by MRI 1.4, mean cores from each MRI target lesion 3 (CI 2-5), mean total cores 15 ( CI 12-19). Group B (37 patients): mean age 66 years (CI 49-77), mean PSA= 4.7 (3.2- 7.9); mean prostate volume 45 ml (33-67), DRE positive in 5/37, mean total cores 14 ( CI 10-16) Results: In Group A 10/22 patients were positive for PCA (overall detection rate of 45.5%): 6 PCA were detected by target biopsy and 4 cancer by random biopsy. Significant prostate cancer (defined as the presence of Gleason pattern 4) was detected in 4/10 patients (Significant PCA detection rate of 40%) and all significant PCA were detected by MRI target biopsy. All PCA detected by random biopsy had Gleason score 3 + 3 = 6. In Group B (biopsy naïve patients) 14/37 patients were positive for PCA (overall detection rate of 37.8%), Significant prostate cancer was detected in 5/14 patients (Significant PCA detection rate of 35,7%). No significant side effects were recorded. Conclusions: Our overall detection rate was 45.5% and 37.8% in Group A (patients with previous negative biopsy and persistent suspicion of PCA) and in Group B (biopsy naïve patients) respectively; clinical significant PCA detection rate was respectively 40% and 35.7%. These results are similar to current literature and promising for the future. We believe that using platforms of co-registered MRI/US fusion biopsy can potentially improve risk stratification and reduces understaging, undergrading and the need for repeat biopsies in biopsy naïve patients (using a stereotactic first mapping) and in patients with previous negative biopsy and persistent suspicion of PCA ( using a second MRI/US fusion biopsy).

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Published
2016-12-30
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Section
SIEUN Congress: Original Articles
Keywords:
MRI/US fusion biopsy, Prostate cancer, Prostate biopsy
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  • PDF: 972
How to Cite
Lacetera, V., Cervelli, B., Cicetti, A., Gabrielloni, G., Montesi, M., Morcellini, R., Parri, G., Recanatini, E., Giglioni, G., Galosi, A. B., & Beatrici, V. (2016). MRI/US fusion prostate biopsy: Our initial experience. Archivio Italiano Di Urologia E Andrologia, 88(4), 296-299. https://doi.org/10.4081/aiua.2016.4.296