Lesion location agreement between prostatic multiparametric magnetic resonance, cognitive fusion biopsy and radical prostatectomy piece

  • Mario Lourenço Urology department Portuguese Institute of Oncology Coimbra, Portugal.
  • Pedro Pissarra Radiology Department Coimbra Hospital University Centre, Coimbra, Portugal.
  • Duarte Vieira e Brito | duartevbrito@hotmail.com Urology Department Portuguese Institute of Oncology Coimbra, Coimbra, Portugal.
  • Miguel Eliseu Urology and Kidney Transplant Department Coimbra Hospital University Centre, Coimbra, Portugal.
  • Joao Pedro Peralta Urology Department Portuguese Institute of Oncology Coimbra, Coimbra, Portugal.
  • Arnaldo Figueiredo Urology and Kidney Transplant Department Coimbra Hospital University Centre, Coimbra, Portugal.
  • Cristina Marques Radiology Department Coimbra Hospital University Centre, Coimbra, Portugal.

Abstract

Introduction: Prostatic multiparametric magnetic resonance (mpMRI) allows for guided prostate biopsy (PB).
Objective: To evaluate localization agreement between mpMRI lesions and histology obtained by cognitive PB and radical prostatectomy (RP) surgical specimen (SS).
Methods: Out of 115 consecutive cognitive biopsied patients, 37 with positive PB were studied. Sample was characterized regarding age, prostatic volume, PI-RADS, location of lesion on mpMRI, lesion dimension, total number of fragments obtain by PB, number of fragments directed to the lesion, number of fragments with prostatic adenocarcinoma (PCa) and ISUP classification. The relationship between mpMRI and SS piece was analysed in 15 patients who underwent RP.
Results: Regarding agreement between mpMRI and PB, agreement of location was observed in 26 (70.3%); 7 (18.9%) presented PCa positive fragments in the suspected zone plus others in the same lobe; 3 (8.1%) in the suspected zone plus the contralateral lobe and 1 (2.7%) had no PCa in the suspected zone but had bilateral PCa. The total number of fragments with PCa was lower in cases with agreement between mpMRI and PB (p < 0.05). Regarding agreement between mpMRI and SS, 5 cases (33.3%) presented the same location as described by mpMRI, 5 (33.3%) showed ipsilateral lesions in other zones of the prostate; 4 (26.7%) presented extensive bilateral lesions on all prostate zones and 1 (6.7%) showed previously unknown contralateral lesions. None of the factors studied related mpMRI and RP (p > 0.05).
Conclusions: Localization agreement of mpMRI vs PB and mpMRI vs SS was present in 26/37 (70.3%) and 5/15 (33.3%), respectively. That suggests the existence of other lesions (multifocality) not identified on mpMRI.

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Published
2020-01-13
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Section
Original Papers - Oncology
Keywords:
prostate biopsy, cognitive prostate biopsy, multiparametric magnetic resonance imaging, prostate cancer, localization agreement, multifocality
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How to Cite
Lourenço, M., Pissarra, P., e Brito, D., Eliseu, M., Peralta, J. P., Figueiredo, A., & Marques, C. (2020). Lesion location agreement between prostatic multiparametric magnetic resonance, cognitive fusion biopsy and radical prostatectomy piece. Archivio Italiano Di Urologia E Andrologia, 91(4), 218-223. https://doi.org/10.4081/aiua.2019.4.218