Prostate cancer detection with transrectal MRI-USG fusion targeted prostate biopsy

Abstract

Objective: To study the detection of clinically significant prostate cancer (PCa) with transrectal MRI-USG fusion prostate biopsy. Patients & Methods: Data of patients who underwent transrectal MRI-USG fusion targeted prostate biopsy were prospectively collected. Inclusion criteria were Chinese patients with previous MRI prostate, no known history of PCa and PSA level between 4-20ng/mL. Results: 417 patients fulfilled the inclusion criteria between July 2015 and March 2019. 258 and 159 patients had first prostate biopsy and previous negative prostate biopsy respectively. The overall cancer detection rate is significantly higher in the fusion group (32.6% vs 25.7%). A significantly higher proportion of PCa with Gleason Score (GS) ≥ 7 was detected in targeted biopsy cores when compared to templated biopsy cores (69% vs 46.3%). There is also significantly higher proportion of PCa with GS ≥ 7 detected with fusion biopsy (75% vs 57%) in the first biopsy group and similar proportion of PCa with GS ≥ 7 detected (70% vs 71%) in the previous negative biopsy group. The area under the curve (AUC) of ROC curve for PIRADS + PHI + PSAD + Age + Biopsy + DRE is 0.85. Overall sepsis rate was 1.7%. Conclusion: Our study has demonstrated transrectal MRI-USG fusion targeted prostate biopsy detected more clinically significant cancers in biopsy-naive Chinese men.