Transperineal magnetic resonance image guided prostate biopsy.
OBJECTIVE
We report the findings of a transperineal magnetic resonance image (MRI) guided biopsy of the prostate in a man with increasing prostate specific antigen who was not a candidate for a transrectal ultrasound guided biopsy.


METHODS
Using an open configuration 0.5 Tesla MRI scanner and pelvic coil, a random sextant sample was obtained under real time MRI guidance from the peripheral zone of the prostate gland as well as a single core from each MRI defined lesion. The patient had previously undergone proctocolectomy for ulcerative colitis and, therefore, was not a candidate for transrectal ultrasound guided biopsy. Prior attempts to make the diagnosis of prostate cancer using a transurethral approach were unsuccessful.


RESULTS
The random sextant samples contained benign prostatic hyperplasia, whereas Gleason grade 3 + 3 = 6 adenocarcinoma was confirmed in 15% and 25% of the 2 cores obtained from the MRI targeted specimens of 2 defined lesions. The procedure was well tolerated by the patient.


CONCLUSIONS
Transperineal MRI guided biopsy is a new technique that may be useful in detecting prostate cancer in men with increasing prostate specific antigen who are not candidates for transrectal ultrasound guided biopsy.
D'Amico
A V
AV
Departments of Radiation Oncology, Radiology, Pathology and Urology, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Tempany
C M
CM
Cormack
R
R
Hata
N
N
Jinzaki
M
M
Tuncali
K
K
Weinstein
M
M
Richie
J P
JP
D000230:Adenocarcinoma / Q000473:pathology; D000368:Aged; D001706:Biopsy / Q000379:methods*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D010537:Peritoneum; D011467:Prostate / Q000473:pathology*; D011470:Prostatic Hyperplasia / Q000473:pathology; D011471:Prostatic Neoplasms / Q000473:pathology*