Comparison between Transrectal Ultrasound Guided Prostatic Biopsy versus Multiparametric Magnetic Resonance Imaging with Subsequent Magnetic Resonance Imaging Prostatic Guided Target Biopsy in Suspected Cancer Prostate Patients

Abstract

Background: Prostate cancer (PCA) is the most frequent cancer among men. In order to overcome the practical limitations of prostate  specific antigen (PSA) screening, research in recent years has focused on developing more precise imaging techniques.

Objectives: This  study aimed to determine the function of multiparametric magnetic resonance imaging (mpMRI) as a prebiopsy imaging decreasing the  number of biopsies taken and role of combination of mpMRI finding with standard transrectal ultrasound (TRUS) guided biopsy findings  to improve efficacy of standard TRUS biopsy.

Patients and methods: This prospective study trial was completed on 124 patients  suspicious for cancer prostate as elevated total PSA > 10 ng/ml or in grey zone and free/total ratio less than 0.18 or suspicious digital  rectal examination who attended to the Urology Department of Benha University Hospital. All patients underwent mpMRI then TRUS  guided systematic biopsy. Further to that, TRUS guided targeted biopsy by cognitive biopsy technique from suspicious lesions in the  same session for those who had positive mpMRI finding.

Results: Regarding the agreement and performance characteristics between  combined systematic and targeted biopsy in relation to systematic biopsy alone among patients suspected of having prostate cancer,  showed moderate agreement (k=0.499), with 73.2 % sensitivity, 77.3 % specificity, 80.4 % PPV, 69.4 % NPV and 75.0 % accuracy.  

Conclusions: Combined TRUS guided and Targeted biopsy improved cancer detection rate in patients with PIRADs 2, 3, 4.