Clinical utility of endorectal MRI-guided prostate biopsy: preliminary experience

J Magn Reson Imaging. 2014 Aug;40(2):314-23. doi: 10.1002/jmri.24383. Epub 2013 Oct 31.

Abstract

Purpose: To investigate the potential clinical utility of endorectal MRI-guided biopsy in patients with known or suspected prostate cancer.

Materials and methods: We prospectively recruited 24 men with known or suspected prostate cancer in whom MRI-guided biopsy was clinically requested after multiparametric endorectal MRI showed one or more appropriate targets. One to six 18-gauge biopsy cores were obtained from each patient. Transrectal ultrasound guided biopsy results and post MRI-guided biopsy complications were also recorded.

Results: MRI-guided biopsy was positive in 5 of 7 patients with suspected prostate cancer (including 2 of 4 with prior negative ultrasound-guided biopsies), in 8 of 12 with known untreated prostate cancer (including 5 where MRI-guided biopsy demonstrated a higher Gleason score than ultrasound guided biopsy results), and in 3 of 5 with treated cancer. MRI-guided biopsies had a significantly higher maximum percentage of cancer in positive cores when compared with ultrasound guided biopsy (mean of 37 ± 8% versus 13 ± 4%; P = 0.01). No serious postbiopsy complications occurred.

Conclusion: Our preliminary experience suggests endorectal MRI-guided biopsy may safely contribute to the management of patients with known or suspected prostate cancer by making a new diagnosis of malignancy, upgrading previously diagnosed disease, or diagnosing local recurrence.

Keywords: MR imaging; prostate biopsy; prostate cancer.

Publication types

  • Clinical Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Aged, 80 and over
  • Feasibility Studies
  • Humans
  • Image-Guided Biopsy / methods*
  • Magnetic Resonance Imaging, Interventional / methods*
  • Male
  • Middle Aged
  • Pilot Projects
  • Prostate / pathology*
  • Prostatic Neoplasms / pathology*
  • Rectum*
  • Reproducibility of Results
  • Sensitivity and Specificity