title: Guided e-MRI prostate biopsy can solve the discordance between Gleason score biopsy and radical prostatectomy pathology.
abstract: BACKGROUND
  The aim of this study is to examine if guided prostate biopsies based on abnormalities detected by conventional and functional endorectal magnetic resonance imaging (MRI) yield a more reliable representation of the radical prostatectomy pathology and to identify probable preoperative clinical variables that stratified patients likely to harbor significant upgrading.
  
  
  METHODS
  From April 2004 to April 2009, a review of N=70 patients records diagnosed with prostate cancer by a 3-6 core guided transrectal ultrasound (TRUS) prostate biopsy based on abnormalities detected by conventional and functional endorectal MRI and who subsequently underwent radical prostatectomy and exhibited a significant upgrading was conducted. Additionally, a multivariate analysis with a significant upgrading as the outcome was performed including the following parameters: prostate specific antigen (PSA) level, clinical stage, prostate size and duration from biopsy to radical prostatectomy.
  
  
  RESULTS
  A significant upgrading was noted in only 8.5% of patients, with 1.4% exhibiting a significant downgrading and the rest 90.1% exhibiting an exact Gleason score match. No preoperative clinical variables that stratified patients likely to harbour significant upgrading were identified.
  
  
  CONCLUSIONS
  This type of biopsy method seems to solve the discordance between the biopsy Gleason score and radical prostatectomy pathology regardless of known preoperative clinical variables that can affect it.
authors.affiliation: Department of Urology, Martha Maria Medical Center, Academic Hospital of Erlangen University, Nurnberg, Germany. Labanaris@web.de
authors.forename: Apostolos P
authors.initials: AP
authors.lastname: Labanaris
authors.forename: Vahudin
authors.initials: V
authors.lastname: Zugor
authors.forename: Robert
authors.initials: R
authors.lastname: Smiszek
authors.forename: Reinhold
authors.initials: R
authors.lastname: Nützel
authors.forename: Reinhard
authors.initials: R
authors.lastname: Kühn
authors.forename: Karl
authors.initials: K
authors.lastname: Engelhard
mesh_terms: D001707:Biopsy, Needle / Q000379:methods*; D005240:Feasibility Studies; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000601:surgery*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D025321:Surgery, Computer-Assisted / Q000379:methods*