Targeted Prostate Biopsy: Lessons Learned Midst the Evolution of a Disruptive Technology

Nima Nassiri; Shyam Natarajan; Daniel J Margolis; Leonard S Marks

doi:10.1016/j.urology.2015.07.001

Targeted Prostate Biopsy: Lessons Learned Midst the Evolution of a Disruptive Technology

Urology. 2015 Sep;86(3):432-8. doi: 10.1016/j.urology.2015.07.001. Epub 2015 Jul 10.

Authors

Nima Nassiri¹, Shyam Natarajan², Daniel J Margolis³, Leonard S Marks⁴

Affiliations

¹ Department of Urology, University of California at Los Angeles, Los Angeles, CA.
² Department of Urology, University of California at Los Angeles, Los Angeles, CA; Departments of Urology and Biomedical Engineering, University of California at Los Angeles, Los Angeles, CA.
³ Department of Radiology, University of California at Los Angeles, Los Angeles, CA.
⁴ Department of Urology, University of California at Los Angeles, Los Angeles, CA. Electronic address: Lmarks@mednet.ucla.edu.

Abstract

Lessons learned during a 6-year experience with more than 1200 patients undergoing targeted prostate biopsy via MRI/ultrasound fusion are reported: (1) the procedure is safe and efficient, requiring some 15-20 minutes in an office setting; (2) MRI is best performed by a radiologist with specialized training, using a transabdominal multiparametric approach and preferably a 3T magnet; (3) grade of MRI suspicion is the most powerful predictor of biopsy results, eg, Grade 5 usually represents cancer; (4) some potentially important cancers (15%-30%) are MRI-invisible; (5) Targeted biopsies provide >80% concordance with whole-organ pathology. Early enthusiasm notwithstanding, cost-effectiveness is yet to be resolved, and the technologies remain in evolution.

Publication types

Research Support, N.I.H., Extramural
Review

MeSH terms

Diffusion of Innovation
Humans
Image-Guided Biopsy / instrumentation*
Magnetic Resonance Imaging / instrumentation*
Male
Prostatic Neoplasms / pathology*
Sensitivity and Specificity

Abstract

Publication types

MeSH terms

Grants and funding