MRI/US Fusion Prostate Biopsy Predicts Final Pathology Better

It has lower pathologic upgrade rates at RP compared with standard 12-core biopsy.
It has lower pathologic upgrade rates at RP compared with standard 12-core biopsy.

ORLANDO—Magnetic resonance imaging/ultrasound-fusion prostate biopsy (MRI/US) more accurately predicts whole-gland pathology than standard 12-core biopsy, data presented at the American Urological Association 2014 annual meeting suggest.

Arvin George, MD, of the National Cancer Institute in Bethesda, Md., and collaborators identified 132 patients who underwent standard 12-core MRI-US fusion biopsy and subsequent radical prostatectomy (RP). The cohort had a mean PSA level of 9.9 ng/mL and a mean age of 61.1 years.

Fusion biopsy resulted in the upgrading of 40 patients (30.3%) from 12-core biopsy, 12 of whom had a negative 12-core biopsy, Dr. George's group reported. In addition, 62 patients (46.9%) were upgraded at RP from 12-core biopsy compared with 47 (35.6%) upgraded at RP from fusion biopsy. Eighteen patients (13.5%) with clinically insignificant disease on 12-core biopsy and upgraded to clinically significant high-grade cancer at RP compared only 7 (5.2%) in the fusion biopsy cohort.

“MRI/US fusion prostate biopsy has significantly lower pathologic upgrade rates of [prostate cancer] versus standard 12-core biopsy at RP,” the investigators concluded.

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