Cancer Detection Rates and Inter-Examiner Variability of MRI/TRUS Fusion Targeted Biopsy and Systematic Transrectal Biopsy

Miroslav Záleský, Jiri Stejskal, Ivo Minarik, Marketa Koldova, Vanda Adamcova, Jana Votrubova, Adam Pavlicko, Marek Babjuk and Roman Zachoval

Department of Urology Thomayer Hospital, Prague, Czech Republic
Department of Urology, 1st Medical Faculty, Charles University, Prague, Czech Republic
Department of Urology, Charles University, 2nd Medical School, University Hospital Motol, Czech Republic
Department of Radiology, Thomayer Hospital, Prague, Czech Republic
Department of Urology, 3rd Medical Faculty, Charles University, Prague, Czech Republic

^*Correspondance to: Roman Zachoval 

 PDF  Full Text DOI: 10.25107/2474-1647.2117

Abstract

Objectives: Software-based MRI/TRUS fusion biopsy depends on the coordination of several steps, and inter-examiner differences could influence biopsy results. The aim of this bicentric prospective study was to compare the detection rates of MRI/TRUS fusion Targeted Biopsy (TG) and Systematic Biopsy (SB), and the detection rates of examiners with different levels of previous experience in prostate biopsy.Methods: A total of 419 patients underwent MRI based on a suspicion of prostate cancer with elevated PSA levels. MRI was positive in 395 patients (221 in the first biopsy group [FB] and 174 in the repeated biopsy group [RB]). A subsequent TG, followed by a SB, was performed on these patients by four different examiners.Results: In the detection of clinically significant prostate cancer, a significant difference was found for TG+SB against SB in the RB group (35.1% vs. 25.3%, p=0.047). In the detection of clinically insignificant prostate cancer, the SB had a significantly higher detection rate than TG in both subgroups (FB: 11.9% vs. 4.7%, p=0.008; RB: 13.8% vs. 6.9%, p=0.034). A significant difference was found between the four examiners in the FB for TG (p=0.028), SB (p=0.036), and TG+SB (p=0.017).Conclusion: MRI/TRUS TG in combination with SB had significantly higher detection rates than SB in the RB group only. Differences in detection rates between examiners were dependent on the level of previous experience with TRUS guided biopsy.

Keywords

Biopsy; Diagnostic imaging; Fusion; MRI; Prostatecancer

Cite the article

Z�lesk� M, Stejskal J, Minarik I, Koldova M, Adamcova V, Votrubova J, et al. Cancer Detection Rates and Inter-Examiner Variability of MRI/TRUS Fusion Targeted Biopsy and Systematic Transrectal Biopsy. Clin Surg. 2018; 3: 2117.