Diagnostic Performance of Multiparametric Magnetic Resonance Imaging and Fusion Targeted Biopsy to Detect Significant Prostate Cancer

Anticancer Res. 2017 Dec;37(12):6871-6877. doi: 10.21873/anticanres.12149.


Background/aim: Multiparametric magnetic resonance imaging combined with ultrasound-fusion-targeted biopsy of the prostate intends to increase diagnostic precision, which has to be clarified.

Patients and methods: We performed multiparametric magnetic resonance imaging followed by ultrasound-fusion-guided perineal biopsy in 99 male patients with elevated prostate-specific-antigen and previous negative standard biopsy-procedures.

Results: In 33/99 patients (33%) no malignancy could be confirmed by histopathology. Low-grade carcinomas (Gleason-Score 6+7a) were found in 42/66 (64%) and high-grade carcinomas (Gleason-Score ≥7b) in 24/66 (36%) men. A high-grade carcinoma corresponded to PI-RADS 4 or 5 (suspected malignancy) in 21/24 cases, which accounted for a sensitivity of 88% and negative-predictive-value of 85% (p=0.002). Differentiation between high-/low-grade carcinomas (Gleason-Score ≤7a vs. ≥7b) by means of PI-RADS related to a sensitivity of 88% and a negative-predictive-value of 70% (p=0.74).

Conclusion: The results support the view that multiparametric magnetic resonance imaging/ultrasound-fusion-guided biopsy promotes considerably higher detection rates of clinically relevant prostate malignancies than do conventional diagnostic procedures. With regard to differentiation between high- and low-grade carcinomas, no significant difference was demonstrated.

Keywords: Magnetic resonance imaging; diagnostic imaging; prostatic neoplasms.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Endoscopic Ultrasound-Guided Fine Needle Aspiration
  • Humans
  • Image-Guided Biopsy / methods*
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Neoplasm Grading
  • Prostate / diagnostic imaging*
  • Prostate / pathology
  • Prostate-Specific Antigen / blood
  • Prostatic Neoplasms / diagnosis
  • Prostatic Neoplasms / diagnostic imaging*
  • Prostatic Neoplasms / pathology
  • Reproducibility of Results
  • Sensitivity and Specificity


  • Prostate-Specific Antigen