Journal
UROLOGIA INTERNATIONALIS
Volume 87, Issue 1, Pages 49-53Publisher
KARGER
DOI: 10.1159/000325880
Keywords
Prostate cancer; Magnetic resonance imaging; Prostate biopsy; Negative predictive value; Positive predictive value; Likelihood ratio
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Funding
- Medical Research Council, Pelican Cancer Foundation, Prostate UK
- St Peter's Trust
- Prostate Cancer Research Foundation
- Prostate Cancer Research Centre
- UCL/UCLH NIHR Comprehensive Biomedical Research Centre
- GSK
- USHIFU/Focused Surgery/Misonix Inc.
- Medical Research Council [G0701302, G1002509] Funding Source: researchfish
- National Institute for Health Research [09/22/67] Funding Source: researchfish
- MRC [G0701302, G1002509] Funding Source: UKRI
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Objectives: Overdiagnosis is arguably the greatest challenge in the management of men with prostate cancer. Multi-parametric (mp)-MRI prior to prostate biopsy may have a role in ruling-in and ruling-out clinically significant disease. Patients and Methods: 114 consecutive men at risk of prostate cancer with previous biopsy underwent mp-MRI prior to transrectal ultrasound (TRUS)-guided biopsies. Standard systematic biopsies were carried out with targeting to suspicious areas. Results: 59.6% had cancer detected by TRUS-guided biopsy. Mean age was 63.6 years (SD 9.0). If men had not been biopsied because of a negative mp-MRI, 21% (24/114) with no cancer and 5% (6/114) with clinically insignificant cancer could have avoided a biopsy. However, 4% (4/114) would have been advised to defer a biopsy that demonstrated the presence of clinically significant cancer. Conclusion: mp-MRI may have a role in ruling-in and ruling-out clinically significant prostate cancer in men at risk prior to biopsy. Copyright (C) 2011 S. Karger AG, Basel
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