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The role of MRI/TRUS fusion biopsy in the diagnosis of clinically significant prostate cancer

BACKGROUND: The aim of this work is to evaluate the detection rate of magnetic resonance imaging/transrectal ultrasound (MRI/TRUS) fusion-guided biopsy for clinically significant prostate cancers (Cs PCas), with particular interest in biopsy-naive patients and patients in active surveillance. MRI-ta...

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Autores principales: Benelli, Andrea, Vaccaro, Chiara, Guzzo, Sonia, Nedbal, Carlotta, Varca, Virginia, Gregori, Andrea
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7238303/
https://www.ncbi.nlm.nih.gov/pubmed/32489424
http://dx.doi.org/10.1177/1756287220916613
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author Benelli, Andrea
Vaccaro, Chiara
Guzzo, Sonia
Nedbal, Carlotta
Varca, Virginia
Gregori, Andrea
author_facet Benelli, Andrea
Vaccaro, Chiara
Guzzo, Sonia
Nedbal, Carlotta
Varca, Virginia
Gregori, Andrea
author_sort Benelli, Andrea
collection PubMed
description BACKGROUND: The aim of this work is to evaluate the detection rate of magnetic resonance imaging/transrectal ultrasound (MRI/TRUS) fusion-guided biopsy for clinically significant prostate cancers (Cs PCas), with particular interest in biopsy-naive patients and patients in active surveillance. MRI-targeted biopsy improves cancer detection rate (DR) in patients with prior negative biopsies; the current literature focuses on biopsy naive patients. We also evaluated the pathologic concordance between biopsies and surgical specimens. METHODS: MRI/TRUS fusion-guided biopsies were performed between February 2016 and February 2019. Patients with previous negative biopsies, biopsy-naive or in active surveillance (AS) were included. Cs PCas were defined through Epstein’s criteria. RESULTS: A total of 416 men were enrolled. The overall DRs and Cs PCa DRs were 49% and 34.3%, respectively. Cs PCas were 17.2%, 44.9% and 73.4%, respectively for PI-RADS 3, 4 or 5. Among biopsy-naive patients, 34.8% were found to have a Cs PCa, while a 43.6% tumour upgrading was achieved in men with a low risk of PCa. In patients who underwent radical prostatectomy (RP), the concordance between biopsy Gleason score (GS) (bGS) and pathological GS (pGS) was 90.8%. CONCLUSION: Our study highlights the role of MRI/TRUS fusion prostate biopsy in the detection of PCa in patients with previous negative biopsies focusing on Cs PCa diagnosis. The MRI/TRUS fusion biopsy is also emerging as a diagnostic tool in biopsy-naïve patients and deserves a fundamental role in AS protocols. A greater concordance between bGS and pGS can be achieved with targeted biopsies.
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spelling pubmed-72383032020-06-01 The role of MRI/TRUS fusion biopsy in the diagnosis of clinically significant prostate cancer Benelli, Andrea Vaccaro, Chiara Guzzo, Sonia Nedbal, Carlotta Varca, Virginia Gregori, Andrea Ther Adv Urol Original Research BACKGROUND: The aim of this work is to evaluate the detection rate of magnetic resonance imaging/transrectal ultrasound (MRI/TRUS) fusion-guided biopsy for clinically significant prostate cancers (Cs PCas), with particular interest in biopsy-naive patients and patients in active surveillance. MRI-targeted biopsy improves cancer detection rate (DR) in patients with prior negative biopsies; the current literature focuses on biopsy naive patients. We also evaluated the pathologic concordance between biopsies and surgical specimens. METHODS: MRI/TRUS fusion-guided biopsies were performed between February 2016 and February 2019. Patients with previous negative biopsies, biopsy-naive or in active surveillance (AS) were included. Cs PCas were defined through Epstein’s criteria. RESULTS: A total of 416 men were enrolled. The overall DRs and Cs PCa DRs were 49% and 34.3%, respectively. Cs PCas were 17.2%, 44.9% and 73.4%, respectively for PI-RADS 3, 4 or 5. Among biopsy-naive patients, 34.8% were found to have a Cs PCa, while a 43.6% tumour upgrading was achieved in men with a low risk of PCa. In patients who underwent radical prostatectomy (RP), the concordance between biopsy Gleason score (GS) (bGS) and pathological GS (pGS) was 90.8%. CONCLUSION: Our study highlights the role of MRI/TRUS fusion prostate biopsy in the detection of PCa in patients with previous negative biopsies focusing on Cs PCa diagnosis. The MRI/TRUS fusion biopsy is also emerging as a diagnostic tool in biopsy-naïve patients and deserves a fundamental role in AS protocols. A greater concordance between bGS and pGS can be achieved with targeted biopsies. SAGE Publications 2020-05-18 /pmc/articles/PMC7238303/ /pubmed/32489424 http://dx.doi.org/10.1177/1756287220916613 Text en © The Author(s), 2020 https://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Research
Benelli, Andrea
Vaccaro, Chiara
Guzzo, Sonia
Nedbal, Carlotta
Varca, Virginia
Gregori, Andrea
The role of MRI/TRUS fusion biopsy in the diagnosis of clinically significant prostate cancer
title The role of MRI/TRUS fusion biopsy in the diagnosis of clinically significant prostate cancer
title_full The role of MRI/TRUS fusion biopsy in the diagnosis of clinically significant prostate cancer
title_fullStr The role of MRI/TRUS fusion biopsy in the diagnosis of clinically significant prostate cancer
title_full_unstemmed The role of MRI/TRUS fusion biopsy in the diagnosis of clinically significant prostate cancer
title_short The role of MRI/TRUS fusion biopsy in the diagnosis of clinically significant prostate cancer
title_sort role of mri/trus fusion biopsy in the diagnosis of clinically significant prostate cancer
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7238303/
https://www.ncbi.nlm.nih.gov/pubmed/32489424
http://dx.doi.org/10.1177/1756287220916613
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