MRI ultrasound fusion biopsy in prostate cancer detection: Are randomized clinical trials reproducible in everyday clinical practice?

Cattarino, Susanna; Forte, Valerio; Salciccia, Stefano; Drudi, Francesco Maria; Cantisani, Valerio; Sciarra, Alessandro; Fasulo, Andrea; Ciccariello, Mauro

doi:10.1177/0391560319834490

Cited by 6 publications

(7 citation statements)

References 22 publications

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“…Only a few studies have concluded that bpMRI can be used instead of mpMRI to guide MRI/US fusion-targeted biopsy [ 48 ]. Some authors argue that, while mpMRI-ultrasound fusion biopsy is associated with high cancer detection rates in clinically significant PCa, it has some limitations that TRUS biopsies alone do not have [ 74 , 76 ].…”

Section: Discussionmentioning

confidence: 99%

Could Biparametric MRI Replace Multiparametric MRI in the Management of Prostate Cancer?

Iacob

Stoicescu

Cerbu

et al. 2023

Life

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Prostate cancer (PCa) is a worldwide epidemiological problem, since it is one of the most prevalent types of neoplasia among men, and the third-leading cause of cancer-related deaths, after lung and colorectal tumors. Unfortunately, the early stages of PCa have a wide range of unspecific symptoms. For these reasons, early diagnosis and accurate evaluation of suspicious lesions are crucial. Multiparametric MRI (mpMRI) is currently the imaging modality of choice for diagnostic screening and local staging of PCa, but also has a leading role in guiding biopsies and in treatment biparametric MRI (bpMRI) could partially replace mpMRI due to its lack of adverse reactions caused by contrast agents, relatively lower costs, and shorter acquisition time. Further, 31 relevant articles regarding the advantages and disadvantages of the aforementioned imaging techniques were scanned. As a result, while bpMRI has comparable accuracy in detecting PCa, its roles in the other steps of PCa management are limited.

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Section: Discussionmentioning

confidence: 99%

Could Biparametric MRI Replace Multiparametric MRI in the Management of Prostate Cancer?

Iacob

Stoicescu

Cerbu

et al. 2023

Life

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“…A systematic review and meta-analysis from 13 studies showed the overall pooled sensitivity of PSMA PET/CT for staging in prostate cancer were 92% (30). MRI-US fusion-guided biopsies detected more clinically significant cancers than standard biopsy techniques (12,17,(31)(32)(33). In our study, prostate biopsies performed on targeted 18 F-DCFPyL PET-positive lesions of 55 patients had a high detection rate (51/55, 92.7%) of prostate cancer, and a high proportion (85.5%, 47/55) were clinically significant prostate cancer.…”

Section: Discussionmentioning

confidence: 99%

A Pilot Study of 18F-DCFPyL PET/CT or PET/MRI and Ultrasound Fusion Targeted Prostate Biopsy for Intra-Prostatic PET-Positive Lesions

Liu¹,

Yu²,

Liu³

et al. 2021

Front. Oncol.

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ObjectivesThe purpose of this study was to evaluate the feasibility and diagnostic performance of prostate-specific membrane antigen (PSMA) based 18F-DCFPyL PET/CT-ultrasound (PET/CT-US) or PET/MRI-ultrasound (PET/MRI-US) fusion targeted biopsy for intra-prostatic PET-positive lesions.MethodsFrom April 2018 to November 2019, we prospectively enrolled 55 candidates to perform PET/CT-US or PET/MRI-US fusion targeted biopsies for solitary PET-positive prostate lesions (two to four cores/lesion). The positive rates of prostate cancer based on patients and biopsy cores were calculated respectively. With reference to the pathological results of biopsy cores, the MR signal characteristics in the area of the PET-positive lesion were analyzed for the patients who underwent PET/MRI.ResultsA total of 178 biopsy cores were taken on the 55 patients. One hundred forty-six biopsy cores (82.0%, 146/178) from 51 (92.7%, 51/55) patients were positive for prostate cancer; 47 (85.5%, 47/55) were clinically significant prostate cancer. It is noteworthy that nine patients underwent both 18F-DCFPyL PET/CT and PET/MRI examinations; the seven patients with prostate cancer showed abnormal MR signal in the area of the PET-positive lesion while the other two patients with prostatic hyperplasia and prostatitis showed normal MR signal in the area of the PET-positive lesion.ConclusionThis study indicated that 18F-DCFPyL PET/CT-US or PET/MRI-US fusion targeted prostate biopsies may be valuable for prostate cancer diagnosis and have a high detection rate of clinically significant prostate cancer for PET-positive lesions. PET/MR can rule out some false PET-positive lesions, which may potentially reduce unnecessary prostate biopsies.

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“…Previous studies have shown that the higher the prostate lesion PI-RADS scores in patients, the greater the value of TRUS/MRI fusion-guided biopsy. 5,7 However, the use of PI-RADS for lesion scoring is mainly based on qualitative images of different Mp-MRI sequences and there is a lack of objective quantitative parameters. Hence, the results tend to be affected by the experience of the interpreting radiologist.…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, the selection of suitable proatate lesions for TRUS/MRI fusion‐guided biopsy is worthy of our attention. Previous studies have shown that the higher the prostate lesion PI‐RADS scores in patients, the greater the value of TRUS/MRI fusion‐guided biopsy 5,7 . However, the use of PI‐RADS for lesion scoring is mainly based on qualitative images of different Mp‐MRI sequences and there is a lack of objective quantitative parameters.…”

Section: Introductionmentioning

confidence: 99%

Value of synthetic MRI quantitative parameters in preprocedural evaluation for TRUS/MRI fusion‐guided biopsy of the prostate

Cao

et al. 2023

The Prostate

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Background Transrectal ultrasonography (TRUS)/magnetic resonance imaging (MRI) fusion‐guided biopsy has a high clinical application value. However, this technique has some limitations, which limit its use in routine clinical practice. Therefore, the selection of suitable proatate lesions for this technique is worthy of our attention. Synthetic MRI (SyMRI) is capable of quantifying multiple relaxation parameters, which might have potential value in preprocedural evaluation for TRUS/MRI fusion‐guided biopsy of the prostate. The aim of our study is to examine the value of SyMRI quantitative parameters in preprocedural evaluation for TRUS/MRI fusion‐guided biopsy of the prostate. Methods We prospectively selected 148 lesions in 137 patients who underwent prostate biopsy in our hospital. Next, 2–4 needles of TRUS/MRI fusion‐guided biopsy combined with 10 needles of system biopsy (SB) were used as the protocol for prostate biopsy. Before biopsy, the MAGiC sequences of the MRI images of the enrolled patients underwent post‐processing, and the longitudinal relaxation time (T1), transverse relaxation time (T2), and proton density (PD) were extracted. The biopsy pathology results were used as a gold standard to compare the differences in SyMRI quantitative parameters between benign and malignant prostate lesions in the peripheral and transitional zones. The receiver operating characteristic (ROC) curves were plotted to confirm the optimal SyMRI quantitative parameter for prostate lesion benignancy/malignancy performance, and the cutoff values of these parameters were used for grouping the lesions. The single‐needle biopsy prostate cancer (PCa)‐positivity rates (number of positive biopsy needles/total biopsy needles) and PCa overall detection rates by TRUS/MRI fusion‐guided biopsy and SB were compared in different subgroups. Results The T1 and T2 values can determine the benignancy/malignancy of prostate transition lesions(p < 0.01), and the T2 value has a greater diagnostic performance (p = 0.0376). The T2 value can determine the benignancy/malignancy of prostate peripheral lesions. The optimal diagnostic cutoff values for T2 were 77 and 81 ms, respectively. The single‐needle PCa positivity rate of TRUS/MRI fusion‐guided biopsy was higher than SB for any prostate lesions in different subgroups (p < 0.01). However, only in the subgroup of transition zone lesions with T2 ≤ 77 ms, the PCa overall detection rate of TRUS/MRI fusion‐guided biopsy was significantly higher than that of SB (p = 0.031). Conclusion SyMRI‐T2 value can provide a theoretical basis for the selection of suitable lesions for TRUS/MRI fusion‐guided biopsy.

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MRI ultrasound fusion biopsy in prostate cancer detection: Are randomized clinical trials reproducible in everyday clinical practice?

Cited by 6 publications

References 22 publications

Could Biparametric MRI Replace Multiparametric MRI in the Management of Prostate Cancer?

Could Biparametric MRI Replace Multiparametric MRI in the Management of Prostate Cancer?

A Pilot Study of 18F-DCFPyL PET/CT or PET/MRI and Ultrasound Fusion Targeted Prostate Biopsy for Intra-Prostatic PET-Positive Lesions

Value of synthetic MRI quantitative parameters in preprocedural evaluation for TRUS/MRI fusion‐guided biopsy of the prostate

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