Optimal timing of post-biopsy MR imaging of the prostate

Ikonen, S.; Kivisaari, L.; Vehmas, Tapio; Tervahartiala, Pekka; Salo, J.; Taari, Kimmo; Rannikko, S.

doi:10.1080/028418501127346260

Cited by 55 publications

(13 citation statements)

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“…Even if we deferred the MR examination for more than 3 weeks after biopsy, as it is classically recommended [35,36], 14.1% (130/920) of the prostate sectors showed bleeding artifacts in our study. As expected, these artifacts decreased the accuracy of tumor localization, both on T2w and DCE images.…”

Section: Discussionmentioning

confidence: 49%

Prostate dynamic contrast-enhanced MRI with simple visual diagnostic criteria: is it reasonable?

et al. 2006

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Section: Discussionmentioning

confidence: 49%

Prostate dynamic contrast-enhanced MRI with simple visual diagnostic criteria: is it reasonable?

et al. 2006

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“…For those patients who have an underlying coagulopathy or are on warfarin, a prostate biopsy should not be taken until the international normalized ratio has been corrected to < 1.5 [6]. Several studies have reported that the haemorrhaging diminishes with time [1,4,5]. We also noted a statistically significant negative correlation between the sum of the haemorrhage score and the time from the biopsy.…”

Section: Discussionmentioning

confidence: 51%

“…Among these factors, haemorrhaging after biopsy is the most common obstacle to the accurate detection of prostate cancer after a prostatic biopsy. Based on a review of previous reports, some authors recommend deferring MRI for ≥ 3 weeks after a prostate biopsy [1,4]. However, another reported that timing has no significant effect on cancer localization [5].…”

Section: Introductionmentioning

confidence: 99%

The effects of the period between biopsy and diffusion‐weighted magnetic resonance imaging on cancer staging in localized prostate cancer

Park¹,

Lee²,

Lim³

et al. 2010

BJU International

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Study Type – Diagnosis (exploratory cohort) Level of Evidence 2b OBJECTIVES To investigate whether there are any differences between preoperative magnetic resonance imaging (MRI) and the final pathology results, based on the time between biopsy and preoperative MRI, as there are reports recommending ≥3 weeks after a prostate biopsy, primarily because haemorrhaging interferes with the interpretation of MRI. PATIENTS AND METHODS Between December 2007 and December 2008, we retrospectively analysed 69 consecutive patients who had biopsy‐confirmed prostate cancer. The inclusion criteria for the study were a history of MRI investigation (combined T2‐weighted and diffusion‐weighted MRI) and robot‐assisted laparoscopic radical prostatectomy. The exclusion criteria included an MRI investigation‐to‐surgery interval of ≥1 week, a biopsy having been taken in another hospital, or other than 12 biopsy cores. The amount of haemorrhaging, number of haemorrhaging sites, and the location of the cancer were determined. For this, the prostate was divided into 12 segments which anatomically corresponded to the sites where the 12 core biopsies were taken. Each haemorrhagic prostate segment was scored according to its diameter. Pathology results were reviewed in the same manner. Finally, we assessed any discordance between the sets of results according to the period between the biopsy and the MRI. The association between the MRI and pathology results, in relation to the period between the biopsy and MRI, was plotted and tested using Pearson’s correlation coefficient. RESULTS Five of the 69 patients were excluded because they had a biopsy at another hospital, 12 were excluded because the period between the MRI and the surgery was >7 days. Suspected prostate haemorrhage was detected in 49 of 52 (94%) patients who had MRI. There was a significantly negative correlation with the period between biopsy and MRI (coefficient – 0.285, P= 0.041). There were no significant differences in cancer localization between MRI and pathology results according to the period between the biopsy and MRI (coefficient 0.028, P= 0.874). The rate of matching between MRI results and pathology results was 74%. CONCLUSIONS We found no significant differences in cancer localization between MRI and final pathology according to the period between the biopsy and MRI. Because of this finding, we do not recommend deferring MRI for the purpose of more accurate cancer staging.

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“…Transrectal needle biopsy results in periprostatic inflammation, and the potential for bleeding and haematoma [3,4]. In the study of Ikonen et al [5], assessing endorectal MRI after prostate biopsy, 77% of patients had visible haemorrhage after biopsy. These effects diminished after 21 days, with an obvious decrease in the amount of blood by 28 days.…”

Section: Discussionmentioning

confidence: 99%

Interval from prostate biopsy to robot‐assisted radical prostatectomy: effects on perioperative outcomes

et al. 2009

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OBJECTIVE To determine whether shorter intervals (<4 and 6 weeks) between prostate biopsy and robot‐assisted radical prostatectomy (RARP) have a detrimental effect on perioperative outcomes, as recent studies showed that open RP shortly after prostate biopsy does not adversely influence surgical difficulty or efficacy, but RARP relies solely on visual cues rather than tactile sensation to determine posterior surgical planes of dissection. PATIENTS AND METHODS A series of 559 patients undergoing RARP from March 2004 to July 2007 was retrospectively reviewed. The interval between prostate biopsy and RARP was determined and patients with intervals of ≤4 weeks were compared to those >4 weeks. Patient characteristics and perioperative outcomes were analysed to determine statistically significant differences between the groups. This comparison was then repeated with a ≤6‐ vs >6‐week interval, and examined with a multivariate logistic regression analysis. RESULTS In the ≤4‐week group (27 patients) vs the >4‐week group (509 patients), there was a significantly (P < 0.05) higher rate of complications (18.5% vs 6.9%). In the ≤6‐week group (81 patients) vs the >6‐week group (455 patients) there was a smaller but still significantly higher rate of complications (13.6% vs 6.4%). These results were still significant when controlling for patient and disease characteristics and the ‘learning curve’. There was also a significantly higher rate of transfusion in the ≤6‐week group (3.7%) than the >6‐week group (0.7%). CONCLUSIONS Our data suggest that RARP should be delayed after prostate biopsy; RARP within 6 weeks of biopsy was associated with a greater risk of complications even when controlling for disease and patient characteristics.

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Optimal timing of post-biopsy MR imaging of the prostate

Abstract: Deferring MR imaging for at least 3 weeks after prostatic biopsy is advisable. T1-weighted images are necessary to rule out false-positive findings caused by post-biopsy hemorrhage.

Cited by 55 publications

References 0 publications

Prostate dynamic contrast-enhanced MRI with simple visual diagnostic criteria: is it reasonable?

Prostate dynamic contrast-enhanced MRI with simple visual diagnostic criteria: is it reasonable?

The effects of the period between biopsy and diffusion‐weighted magnetic resonance imaging on cancer staging in localized prostate cancer

Interval from prostate biopsy to robot‐assisted radical prostatectomy: effects on perioperative outcomes

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