title: Patient selection determines the prostate cancer yield of dynamic contrast-enhanced magnetic resonance imaging-guided transrectal biopsies in a closed 3-Tesla scanner.
abstract: OBJECTIVE
  To evaluate the cancer yield of transrectal prostate biopsies in a 3-T magnetic resonance imaging (MRI) scanner in patients with elevated prostate specific antigen (PSA) levels and recent negative transrectal ultrasonography (TRUS)-guided prostate biopsies.
  
  
  METHODS
  Between July 2004 and November 2005, patients with at least one previous negative prostate biopsy within the previous 12 months had MRI-guided biopsy of the prostate in a 3-T MRI scanner. Patients with previous positive biopsies for cancer were excluded. Target selection was based on T2-weighted imaging and dynamic contrast-enhanced (DCE) imaging studies.
  
  
  RESULTS
  Thirteen patients were eligible; their median (range) age was 61 (47-74) years and PSA value 4.90 (1.3-12.3) ng/mL. Most patients had one previous negative biopsy (range 1-4). Four patients had a family history of prostate cancer. There were 37 distinct targets based on T2-weighted imaging. Fifteen of 16 distinct DCE abnormalities were co-localized with a target based on T2-weighted imaging. Despite this correlation, only one of 13 patients had a directed biopsy positive for cancer. Including systematic biopsies, two of 13 patients had a biopsy positive for prostate cancer. One patient had prostate intraepithelial neoplasia and one had atypical glands in the specimen.
  
  
  CONCLUSIONS
  The prostate-cancer yield of transrectal biopsies in a 3-T MRI scanner, among patients with recent negative TRUS-guided prostate biopsies, is similar to repeat systematic TRUS-guided biopsy. DCE correlates with T2-imaging but does not appear to improve prostate cancer yield in this population.
authors.affiliation: Radiation Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892-1642, USA. Anurag.Singh@RoswellPark.org
authors.forename: Anurag K
authors.initials: AK
authors.lastname: Singh
authors.forename: Axel
authors.initials: A
authors.lastname: Krieger
authors.forename: Jean-Baptiste
authors.initials: JB
authors.lastname: Lattouf
authors.forename: Peter
authors.initials: P
authors.lastname: Guion
authors.forename: Robert L
authors.initials: RL
authors.lastname: Grubb
authors.forename: Paul S
authors.initials: PS
authors.lastname: Albert
authors.forename: Greg
authors.initials: G
authors.lastname: Metzger
authors.forename: Karen
authors.initials: K
authors.lastname: Ullman
authors.forename: Sharon
authors.initials: S
authors.lastname: Smith
authors.forename: Gabor
authors.initials: G
authors.lastname: Fichtinger
authors.forename: Iclal
authors.initials: I
authors.lastname: Ocak
authors.forename: Peter
authors.initials: P
authors.lastname: Choyke
authors.forename: Cynthia
authors.initials: C
authors.lastname: Ménard
authors.forename: Jonathan
authors.initials: J
authors.lastname: Coleman
mesh_terms: D000368:Aged; D001707:Biopsy, Needle; D015331:Cohort Studies; D003287:Contrast Media; D051517:Digital Rectal Examination / Q000379:methods; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000592:standards*; D053783:Magnetic Resonance Imaging, Interventional; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011237:Predictive Value of Tests; D011467:Prostate / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000175:diagnosis*; D012680:Sensitivity and Specificity; D018084:Ultrasonography, Interventional
chemical_list: D003287:Contrast Media; D017430:Prostate-Specific Antigen