Accuracy of Diagnosis with Non-contrast Magnetic Resonance Imaging/Transrectal Ultrasound Fusion-Guided Transperineal Prostate Biopsy

Abstract

We evaluated the efficacy of non-contrast magnetic resonance imaging (MRI)/transrectal ultrasound (TRUS) fusionguided transperineal biopsy for the detection of prostatic carcinoma. Methods: Between November 2013 and June 2015, eighty-three men, who presented to the Department of Urology with a clinically suspicious prostatic cancer, underwent non-contrast MRI/TRUS fusion biopsy (FB) (BioJet ® : D&K Technologies, Kanalweg, Germany) and 16-core systematic biopsy (SB). All biopsies were taken through a transperineal template. In 27 patients, the Gleason scores of biopsy specimens were compared to those of radical prostatectomy specimens. Results: The median patient age was 69 years (IQR 67-73) and the median Prostate Specific Antigen (PSA) level was 6.6 ng/ ml (IQR 5.2-8.9). Fifty-three patients were diagnosed with prostate cancer (PCa) (64%) by biopsy. The per-core cancer detection rate (CDR) was found to be higher for FB than for SB (32.5 vs 13.3%; p < 0.0001). Although not statistically significant, the CDR for clinically significant PCa was numerically higher for FB than for SB (65.1 vs 58.0%; p = 0.309). The Gleason scores of prostatectomy specimens were assessed to be higher than those of biopsy specimens in 44% of the cases in the FB group and in 37% of those in the SB group. Conclusion: Our study adds to the literature which supports the potential role of non-contrast MRI/TRUS fusion-guided transperineal biopsy in the detection of PCa, with a significantly higher per-core CDR compared with SB.