Abstract
Purpose
Multiparametric MRI (mpMRI) has a potential role for the identification of aggressive
cancer that can be targeted for biopsy. We report the incidence and severity of discordant
information between the pathology found on the transrectal ultrasound (TRUS)–guided
biopsy and the mpMRI findings in patients with favorable or intermediate-risk prostate
cancer referred for brachytherapy.
Methods and Materials
From March 2014 to September 2015, 10/44 consecutive patients with low- or intermediate-risk
prostate cancer referred for brachytherapy presented an aggressive lesion on mpMRI
and underwent an MRI-TRUS fusion-guided transperineal biopsy of the index lesion.
Results
A median of two intraprostatic lesions were detected by mpMRI for each patient. Three
patients had bilateral disease, and seven had unilateral disease on mpMRI. The median
number of cores obtained by MRI-TRUS–guided fusion of the index lesion was 3 (range
2–4). As a result of the re-evaluation consequent to additional information becoming
available after the transperineal biopsy, upgrading of Gleason score occurred in 8
of the 10 patients, which changed the risk group in 9 patients. These changes resulted
in modification of the proposed treatment in 8 patients.
Conclusions
MpMRI-US fusion-targeted biopsy sampling allows detection and characterization of
otherwise undetected aggressive disease, often placing men in higher risk groups and
altering the treatment approach.
Keywords
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Article info
Publication history
Published online: December 02, 2016
Accepted:
November 2,
2016
Received in revised form:
November 2,
2016
Received:
August 29,
2016
Footnotes
Financial disclosure: This study was supported by a grant from the Mutua Madrilena Foundation. Exp number: AP116122013.
Conflict of interest: None of the authors have conflicts of interest to declare.
Identification
Copyright
© 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.
