Yield of concurrent systemic biopsy during MRI-targeted biopsy according to Prostate Imaging Reporting and Data System v
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UROGENITAL
Yield of concurrent systemic biopsy during MRI-targeted biopsy according to Prostate Imaging Reporting and Data System version 2 in patients with suspected prostate cancer Chu Hyun Kim 1 & Chan Kyo Kim 1,2,3
&
Jung Jae Park 4 & Sung Yoon Park 1 & Young Cheol Yoon 1
Received: 3 March 2020 / Revised: 30 May 2020 / Accepted: 7 August 2020 # European Society of Radiology 2020
Abstract Objectives To investigate the yield of concurrent systemic biopsy (SB) during MRI-targeted biopsy (MRTB) as Prostate Imaging Reporting and Data System (PI-RADS) version 2 (v2) interpretations in patients with suspected prostate cancer (PCa). Methods A total of 285 patients with suspected PCa underwent prebiopsy 3-T MRI, followed by MRI-transrectal ultrasound fusion targeted biopsy and concurrent standard SB for lesions with PI-RADS v2 scores 3–5. Detection rates and positive core rates of PCa and clinically significant cancer (CSC) were evaluated. Results In concurrent MRTB and SB, PCa and CSC detection rates were 18.9% and 9.4% for PI-RADS score 3, 45.9% and 32.4% for PI-RADS score 4, and 82.1% and 72.6% for PI-RADS score 5, respectively. Overall detection rate of CSCs (40.0%) for concurrent MRTB and SB was significantly higher than that of MRTB (34.4%, p = 0.004) or SB alone (27.7%, p < 0.001): an increase of 5.6% (16 patients) compared with MRTB alone. For patients with PI-RADS score 4 or 5, the CSC detection rate of concurrent MRTB and SB was 47.0%, an increase of 6.1% when compared with MRTB (40.9%) only (p < 0.001). Of the 110 patients with both MRTB- and SB-positive findings, 22 (20.0%) had the highest Gleason score in SB compared with that in MRTB. In 9.5% (27/285) patients including 12 patients with CSCs, only SB was positive, with negative MRTB. Conclusion Concurrent SB with MRTB based on PI-RADS v2 can yield a higher CSC detection rate compared with MRTB alone in patients with suspected PCa. Key Points • Concurrent SB with MRTB yields an increase of 5.6% CSC detection compared with MRTB alone. • Of both MRTB- and SB-positive findings, 20.0% patients have upgraded Gleason score in SB. • In 18.4% patients, only SB was positive, with negative MRTB. Adding MRTB to SB is helpful for adequate risk stratification, reducing diagnostic uncertainty of PCa. Keywords Prostate cancer . Magnetic resonance imaging . Biopsy . Image-guided biopsy
* Chan Kyo Kim [email protected] 1
Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Republic of Korea
2
Department of Medical Device Management and Research, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea
3
Department of Digital Health, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea
4
Department of Radiology, Chungnam National University Hospital, Daejeon, Republic of Korea
Abbreviations CSC Clinically significant cancer GS Gleason score mpMRI Multiparametric magnetic resonance imaging MRTB MRI-targeted biopsy PCa Prostate cancer PI-RADS Prost
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