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29.04.2020 | Urogenital

MRI-directed high-frequency (29MhZ) TRUS-guided biopsies: initial results of a single-center study

verfasst von: François Cornud, Arnaud Lefevre, Thierry Flam, Olivier Dumonceau, Marc Galiano, Philippe Soyer, Philippe Camparo, Matthias Barral

Erschienen in: European Radiology | Ausgabe 9/2020

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Abstract

Objectives

To evaluate the ability of high-frequency (29 MHz) transrectal micro-ultrasound (microUS) as a second-look examination after biparametric MRI (bp-MRI) and to reidentify focal lesions seen on diagnostic MRI and to detect new ones

Methods

A total of 118 consecutive men (mean age, 66 ± 13 [SD] years; range, 49–93 years) with a mean prostate-specific antigen level of 11 ± 19 (SD) ng/mL (range, 2–200 ng/mL) and at least one focal lesion (MRI+) with a score > 2 on bp-MRI were included. Of these, 79/118 (66.9%) were biopsy-naïve and 102/118 (86.5%) had non-suspicious rectal examination. All patients had MRI-directed microUS-guided biopsy using a 29-MHz transducer. All lesions visible on micro-ultrasound (microUS+) were targeted without image fusion, which was only used for MRI+/microUS− lesions. Significant prostate cancer (sPCa) was defined by a Gleason score ≥ 7 or a maximum cancer core length > 3 mm.

Results

A total of 144 focal prostatic lesions were analyzed, including 114 (114/144, 79.2%) MRI+/microUS+ lesions, 13 MRI+/microUS− lesions (13/144, 9%), and 17 MRI−/microUS+ lesions (17/144, 11.8%). Significant PCa was detected in 70 MRI+/microUS+ lesions (70/114, 61.4%), in no MRI+/microUS− lesion (0/13, 0%), and in 4 MRI-/microUS+ lesions (4/17, 23.5%). The sensitivity and specificity of microUS on a per-patient and a per-lesion basis were 100% (95% CI, 84.9–100%) and 22.8% (95% CI, 12.5–35.8%) and 100% (95% CI, 85.1–100%) and 22.6% (95% CI, 12.3–36.2%), respectively.

Conclusion

MicroUS, as a second-look examination, may show promise to localize targets detected on bp-MRI.

Key Points

• Used as a second-look examination, microUS-guided biopsies have a 100% detection rate of sCa originating in the PZ or lower third of the TZ, without microUS-MRI image fusion.

• MicroUS results may provide additional information about lesions visible on MRI.

• MicroUS may provide the ability to detect small PZ lesions undetected by bp-MRI.

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Titel: MRI-directed high-frequency (29MhZ) TRUS-guided biopsies: initial results of a single-center study
verfasst von: François Cornud
Arnaud Lefevre
Thierry Flam
Olivier Dumonceau
Marc Galiano
Philippe Soyer
Philippe Camparo
Matthias Barral
Publikationsdatum: 29.04.2020
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 9/2020
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-020-06882-x

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MRI-directed high-frequency (29MhZ) TRUS-guided biopsies: initial results of a single-center study