A retrospective study comparing transrectal ultrasound-guided biopsy and magnetic resonance imaging-transrectal ultrasound fusion biopsy for the detection of prostate cancer

Abstract

© JOURNAL OF THE MEDICAL ASSOCIATION OF Thailand | 2019 Objective: To compare the prostate biopsy results in patients that underwent a second transrectal ultrasound (TRUS) biopsy with those obtained from the magnetic resonance imaging (MRI) fusion TRUS biopsy. Materials and Methods: A retrospective review was conducted of the patients with a negative TRUS biopsy who had undergone either a second TRUS biopsy or an MRI fusion TRUS biopsy. Data were collected between January 2015 and July 2017 and included age, biopsy results, pre- operative PSA, prostate imaging reporting and data system (PI-RADS), and prostate volume. Results: Out of the patients that underwent a second prostate biopsy, 39 were performed as MRI fusion TRUS biopsies, and 72 were performed as TRUS biopsies. The MRI fusion TRUS biopsy group had a higher percentage of positive biopsy results (41.0% versus 8.3%, p<0.005). When patients were divided into positive and negative biopsy groups, there was no statistical difference in the serum PSA [10.73 (7.62, 13.58) versus 9.09 (6.42, 11.91), p=0.191], or the prostate volume [33.0 (19.63, 45.58) versus 46.5 (28.49, 49.62), p=0.063]. In the MRI fusion TRUS biopsy group, the biopsies of those patients with PI-RADS score of 3 were all negative (0%), while 45% (10/22) of those with a PI-RADS score of 4 were positive, and 75% (6/8) of those with a PI-RADS score of 5 were positive. Conclusion: Patients with previous negative TRUS biopsies, the MRI fusion TRUS biopsy better detected prostate cancer compared to a second TRUS biopsy alone.