The first Experience of Applying MR/us fusion Biopsy in Prostate Cancer Diagnosis

The incidence of prostate cancer with standard biopsy ranges from 31 to 42 %, but the number of false-negative results remains excessively high. Modern urological trends in the diagnosis of prostate cancer are reduced to the identification of the most malignant tumor node (index lesion), which in fact will determine the disease prognosis and treatment tactics of a particular patient. In this paper, the technique of the procedure and the first results of the MRI / US imaging fusion biopsy – technology is described, which allows to perform targeted biopsy of the prostate gland from the nodules, revealed during the multiparameter MRI, are demonstrated. The use of this technology can increase the number of detected cases of middle and high risk cancer (clinically significant cancer), which allows a more personalized approach to the treatment of this group of patients.

1. Scattoni V., Maccagnano C., Capitanio U. et al.Random biopsy: When, how many and where to take the cores? // World J. Urol. 2014. Vol. 32. P. 859–869. doi:10.1007/s00345-014-1335-0

2. Presti J.C. Prostate biopsy: How many cores are enough? // Urol. Oncol.: Sem. Original Investig. 2003. P. 135–140. doi:10.1016/ S1078-1439(03)00006-1

3. Bjurlin M.A., Wysock J.S., Taneja S.S. Optimization of prostate biopsy: Review of technique and complications // Urol. Clin. North Amer. 2014. Vol. 41. P. 299–313. doi:10.1016/j. ucl.2014.01.011

4. Djavan B., Milani S., Remzi M. Prostate biopsy: who, how and when. An update // Can. J. Urol. 2005. Vol. 12. Suppl 1.

5. Rodríguez-Covarrubias F., González-Ramírez A., AguilarDavidov B. et al. Extended sampling at first biopsy improves cancer detection rate: Results of a prospective, randomized trial comparing 12 versus 18-core prostate biopsy // J. Urol. 2011. Vol. 185. P. 2132–2136. doi:10.1016/j.juro.2011.02.010

6. Ploussard G., Nicolaiew N., Marchand C. et al. Prospective evaluation of an extended 21-core biopsy scheme as initial prostate cancer diagnostic strategy // Eur. Urol. 2014. Vol. 65. P. 154–161. doi:10.1016/j.eururo.2012.05.049

7. Weiner A.B., Patel S.G., Etzioni R. et al. National trends in the management of low and intermediate risk prostate cancer in the United States // J. Urol. 2015. Vol. 193. P. 95–102. doi:10.1016/j.juro.2014.07.111

8. Pokorny M.R., De Rooij M., Duncan E. et al. Prospective study of diagnostic accuracy comparing prostate cancer detection by transrectal ultrasound-guided biopsy versus magnetic resonance (MR) imaging with subsequent MR-guided biopsy in men without previous prostate biopsies // Eur. Urol. 2014. Vol. 66. P. 22–29. doi:10.1016/j.eururo.2014.03.002

9. Sonn G.A., Chang E., Natarajan S. et al. Value of targeted prostate biopsy using magnetic resonance-ultrasound fusion in men with prior negative biopsy and elevated prostate-specific antigen // Eur. Urol. 2014. Vol. 65. P. 809–815. doi:10.1016/j.eururo.2013.03.025

10. Weinreb J.C., Barentsz J.O., Choyke P.L. et al. PI-RADS Prostate Imaging – Reporting and Data System: 2015, Version 2 // Eur. Urol. 2016. Vol. 69. P. 16–40. doi:10.1016/j.eururo.2015.08.052

11. Barentsz J.O., Richenberg J., Clements R. et al. ESUR prostate MR guidelines 2012 // Eur. Radiol. 2012. Vol. 22. P. 746–757. doi:10.1007/s00330-011-2377-y

12. Somford D.M., Hamoen E.H., Utterer J.J. et al. The predictive value of endorectal 3 tesla multiparametric magnetic resonance imaging for extraprostatic extension in patients with low, intermediate and high risk prostate cancer // J. Urol. 2013. Vol. 190. P. 1728–1734. doi:10.1016/j.juro.2013.05.021

13. Delongchamps N.B., Zerbib M. Role of magnetic resonance imaging before initial biopsy: Comparison of magnetic resonance imaging-targeted and systematic biopsy for significant prostate cancer detection // Eur. Urol. 2012. Vol. 61. P. 622–623. doi:10.1016/j.eururo.2011.12.038

14. Hoeks C.M.A., Schouten M.G., Bomers J.G.R. et al. ThreeTesla magnetic resonance-guided prostate biopsy in men with increased prostate-specific antigen and repeated, negative, random, systematic, transrectal ultrasound biopsies: Detection of clinically significant prostate cancers // Eur. Urol. 2012. Vol. 62. P. 902–909. doi:10.1016/j.eururo.2012.01.047

15. Rosenkrantz A.B., Verma S., Choyke P. et al. Prostate magnetic resonance imaging and magnetic resonance imaging targeted biopsy in patients with a prior negative biopsy: a consensus statement by AUA and SAR // J. Urol. 2016. Vol. 196. P. 1613– 1618. doi:10.1016/j.juro.2016.06.079

16. Cash H., Maxeiner A., Stephan C. et al. The detection of significant prostate cancer is correlated with the Prostate Imaging Reporting and Data System (PI-RADS) in MRI/transrectal ultrasound fusion biopsy // World J. Urol. 2016. Vol. 34. P. 525– 32. doi:10.1007/s00345-015-1671-8