303 INCREASED YIELD OF CANCER DETECTION WITH EMRI/US GUIDED FUSED BIOPSY IN PATIENTS WITH PREVIOUS NEGATIVE BIOPSY

You have accessJournal of UrologyProstate Cancer: Staging II1 Apr 2010303 INCREASED YIELD OF CANCER DETECTION WITH EMRI/US GUIDED FUSED BIOPSY IN PATIENTS WITH PREVIOUS NEGATIVE BIOPSY Angelo A. Baccala, Ardeshir R. Rastinehad, Paul H. Chung, Jochen Kruecker, Sheng Xu, Julia K. Locklin, Stacey P. Gates, Joanna H. Shih, Neil D. Glossop, W. Marston Linehan, Gennady Bratslavsky, Baris I. Turkbey, Peter L. Choyke, Bradford J. Wood, and Peter A. Pinto Angelo A. BaccalaAngelo A. Baccala Bethesda, MD More articles by this author , Ardeshir R. RastinehadArdeshir R. Rastinehad Washington, DC More articles by this author , Paul H. ChungPaul H. Chung Bethesda, MD More articles by this author , Jochen KrueckerJochen Kruecker Briarcliff Manor, NY More articles by this author , Sheng XuSheng Xu Briarcliff Manor, NY More articles by this author , Julia K. LocklinJulia K. Locklin Bethesda, MD More articles by this author , Stacey P. GatesStacey P. Gates Frederick, MD More articles by this author , Joanna H. ShihJoanna H. Shih Bethesda, MD More articles by this author , Neil D. GlossopNeil D. Glossop Toronto, ON More articles by this author , W. Marston LinehanW. Marston Linehan Bethesda, MD More articles by this author , Gennady BratslavskyGennady Bratslavsky Bethesda, MD More articles by this author , Baris I. TurkbeyBaris I. Turkbey Bethesda, MD More articles by this author , Peter L. ChoykePeter L. Choyke Bethesda, MD More articles by this author , Bradford J. WoodBradford J. Wood Bethesda, MD More articles by this author , and Peter A. PintoPeter A. Pinto Bethesda, MD More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.366AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Repeat prostate biopsy in patients that had a previously negative biopsy has yielded cancer in as low as 13% of men. Saturation biopsy has increased the yield as a repeat biopsy technique to 34%. The technology associated with Endorectal Coil Multi-Parametric Magnetic Resonance Imaging (eMRI) on a 3 Tesla magnet yields a high signal to noise ratio imaging modality that may be used to localize prostate cancer and guide directed biopsies accordingly. We use a novel platform that registers and fuses real-time trans-rectal ultrasound images with previously obtained MR images. We review our database to determine the yield of our eMRI guided fused biopsy protocol to detect prostate cancer in patients that had a previous negative standard biopsy. METHODS A T3 eMRI is performed pre-operatively. T2 weighted, dynamic contrast enhanced, diffusion weighted, and spectroscopy images were obtained and interpreted. Prostate lesions suspicious for cancer were scored. A traditional 12 core TRUS prostate biopsy is then performed. Prostate US images were then fused to the eMRI images. Biopsies of eMRI targeted lesions were performed using a custom probe with spatial tracking of the biopsy needle by an electromagnetic field (Traxtal Technologies Inc,Canada and Phillips Corporation, Netherlands). We reviewed our database of 101 patients that had an eMRI biopsy and determined those that had a previous standard biopsy. 65 patients met these criteria. They were then evaluated as to outcomes on their eMRI guided fused biopsy and its correlation with previous standard biopsy results. RESULTS Of the 65 patients in our study that had a previous biopsy, 29 were negative and 36 were positive. Of those that were previously negative, 13/29 (48%) were diagnosed with prostate cancer by our methods. CONCLUSIONS eMRI guided sono fused biopsies increase the yield of prostate cancer detection in patients with a previously negative biopsy. This increased yield of 48% vs 34% in repeat saturation biopsy patients represents patients that either may not have been detected or that have had a delay in prostate cancer detection using traditional biopsy criteria and methods. Table 1. Prior Bx PATIENT WITH CANCER N0 Yes Total Negative 16 13 29 Positive 12 24 36 Total 28 37 65 © 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e120-e121 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Angelo A. Baccala Bethesda, MD More articles by this author Ardeshir R. Rastinehad Washington, DC More articles by this author Paul H. Chung Bethesda, MD More articles by this author Jochen Kruecker Briarcliff Manor, NY More articles by this author Sheng Xu Briarcliff Manor, NY More articles by this author Julia K. Locklin Bethesda, MD More articles by this author Stacey P. Gates Frederick, MD More articles by this author Joanna H. Shih Bethesda, MD More articles by this author Neil D. Glossop Toronto, ON More articles by this author W. Marston Linehan Bethesda, MD More articles by this author Gennady Bratslavsky Bethesda, MD More articles by this author Baris I. Turkbey Bethesda, MD More articles by this author Peter L. Choyke Bethesda, MD More articles by this author Bradford J. Wood Bethesda, MD More articles by this author Peter A. Pinto Bethesda, MD More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...