MP48-06 COMPARATIVE ASSESSMENT OF GLEASON SCORING OF PROSTATE BIOPSIES OBTAINED BY STANDARD TRUS AND MRI-TRUS AT FOLLOW UP IN ACTIVE SURVEILLANCE PATIENTS

You have accessJournal of UrologyProstate Cancer: Detection and Screening I1 Apr 2015MP48-06 COMPARATIVE ASSESSMENT OF GLEASON SCORING OF PROSTATE BIOPSIES OBTAINED BY STANDARD TRUS AND MRI-TRUS AT FOLLOW UP IN ACTIVE SURVEILLANCE PATIENTS Max Jackson, Peter Haddock, Ilene Staff, Ryan Dorin, Stuart Kesler, Michael O'Loughlin, Anoop Meraney, and Joseph Wagner Max JacksonMax Jackson More articles by this author , Peter HaddockPeter Haddock More articles by this author , Ilene StaffIlene Staff More articles by this author , Ryan DorinRyan Dorin More articles by this author , Stuart KeslerStuart Kesler More articles by this author , Michael O'LoughlinMichael O'Loughlin More articles by this author , Anoop MeraneyAnoop Meraney More articles by this author , and Joseph WagnerJoseph Wagner More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1680AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Recently developed MRI-TRUS fusion prostate biopsy systems blend MRI imaging with traditional ultrasound in a single platform, allowing high-resolution MRI to be linked to the practicality of ultrasound in an outpatient setting. MRI-TRUS fusion may be particularly useful to determine whether patients are appropriate for active surveillance (AS) and in their follow up. In this study, we examined the ability of standard TRUS and MRI-TRUS in Gleason to detect clinically significant prostate cancer in patients on AS. METHODS Between Jan-Sept 2014, 63 active surveillance patients (all Gleason score 6) diagnosed with a standard TRUS prostate biopsy underwent a 1.5 T MRI with endorectal coil within one year of diagnosis. Regions of interest (ROI) were identified. 12 systematic standard TRUS biopsies were performed as well as 3 cores from each ROI using MRI-TRUS fusion (UroNav). Gleason score ≥ 7 or a single core volume of > 50% prostate cancer was considered clinically significant. Each patient served as their own control. The rate of upgrading to clinically significant cancer by standard biopsies, ROI biopsies, and both methodologies were determined. RESULTS 36.5% (23/63) of patients were found to have clinically significant cancer. Of these, 8.7% (2/23) were identified by MRI-TRUS fusion alone (1 Gleason score ≥7, 1 > 50% Gleason 6). 56.5% (13/23) were identified by standard TRUS alone (12 Gleason score ≥7, 1 > 50% Gleason 6). 34.8% (8/23) were identified by both biopsy methods (7 Gleason score ≥7, 1 > 50% Gleason 6). CONCLUSIONS MRI-TRUS fusion increased the rate of detecting clinically significant cancer by 8.7%. Importantly, performing MRI-TRUS fusion alone and eliminating standard systematic biopsies would have missed 56.5% of clinically significant cancers. Our initial experience with MRI-TRUS fusion contradicts most published series in which MRI-TRUS fusion alone significantly increases the detection rate of clinically significant cancers; some even suggesting that MRI-fusion biopsies alone would be sufficient. We are currently evaluating our MRI-fusion protocols (e.g. quality of MRI images, MRI reading, performance of MRI-TRUS fusion biopsy) to explore potential reasons for these differences. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e596 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Max Jackson More articles by this author Peter Haddock More articles by this author Ilene Staff More articles by this author Ryan Dorin More articles by this author Stuart Kesler More articles by this author Michael O'Loughlin More articles by this author Anoop Meraney More articles by this author Joseph Wagner More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...