Combination of C-TRUS with multiparametric MRI: potential for improving detection of prostate cancer

World J Urol. 2014 Apr;32(2):335-9. doi: 10.1007/s00345-012-0924-z. Epub 2012 Aug 12.


Purpose: To improve the detection of prostate cancer, especially in pre-biopsied patients, a guided biopsy based on radiologic findings is an option. We addressed the question, whether the combination of multiparametric MRI and computerized transrectal ultrasound (C-TRUS) improves the detection of prostate cancer.

Methods: Twenty patients suspicious of having prostate cancer were included. Seventeen patients were pre-biopsied once or more. Each patient was examined by multiparametric MRI and C-TRUS, followed by a guided transrectal prostate biopsy series. Patients were stratified in a "low-risk" and "high-risk" group. The results were analyzed using descriptive statistics.

Results: In 58 % (11 pat.) of patients, prostate cancer was found. In the "high-risk" group, biopsy in 73 % (8 pat.) of patients was positive for prostate cancer. All prostate cancer patients were found by C-TRUS-guided biopsies, whereas MRI did not reveal cancer in 27 %. 72 % (8 pat.) of patients had undergone radical prostatectomy. 65 % (6 pat.) had higher tumor stages after prostatectomy and 62.5 % (5 pat.) had higher Gleason-score.

Conclusions: Combination of multiparametric MRI and C-TRUS seems to improve detection of prostate cancer, especially in high-risk patients. Detection rates of C-TRUS in this study could confirm those of the primary C-TRUS studies. The benefit of MRI is the additional visualization of the tumor extension. The technique is an option for pre-biopsied patients. Both imaging methods often fail to predict correct tumor stage, but further studies are necessary.

MeSH terms

  • Aged
  • Carcinoma / diagnosis*
  • Carcinoma / diagnostic imaging
  • Carcinoma / pathology
  • Diffusion Magnetic Resonance Imaging
  • Humans
  • Image Processing, Computer-Assisted*
  • Image-Guided Biopsy
  • Kallikreins / blood
  • Magnetic Resonance Imaging*
  • Magnetic Resonance Spectroscopy
  • Male
  • Middle Aged
  • Prostate / diagnostic imaging
  • Prostate / pathology*
  • Prostate-Specific Antigen / blood
  • Prostatic Neoplasms / diagnosis*
  • Prostatic Neoplasms / diagnostic imaging
  • Prostatic Neoplasms / pathology
  • Sensitivity and Specificity
  • Ultrasonography


  • Kallikreins
  • kallikrein-related peptidase 3, human
  • Prostate-Specific Antigen