Prospective evaluation of 3-T MRI performed before initial transrectal ultrasound-guided prostate biopsy in patients with high prostate-specific antigen and no previous biopsy.
OBJECTIVE
The purpose of our study was to prospectively evaluate whether MRI before an initial transrectal ultrasound-guided biopsy contributed to detection of prostate cancer in patients with high prostate-specific antigen (PSA) level and no previous biopsy.


METHODS
Men with an abnormal digital rectal examination or high PSA level were enrolled in this prospective randomized study. Participants were randomly allocated into two groups; the MRI group underwent 3-T MRI and then a transrectal ultrasound-guided biopsy with knowledge of the cancer location. The non-MRI group did not undergo MRI before transrectal ultrasound-guided biopsy. The cancer detection rate and positive core rate were obtained to compare the MRI and non-MRI groups.


RESULTS
The MRI and non-MRI groups contained 44 and 41 patients, respectively. There was no significant difference between the two groups with respect to age, PSA, and prostate volume. The MRI group (13/44, 29.5%) had a significantly higher cancer detection rate than the non-MRI group (4/41, 9.8%) (p = 0.03). The MRI group (52/527, 9.9%) had a significantly higher positive core rate than the non-MRI group (11/432, 2.5%) (p = 0.00). Regarding cancer detection rate and positive core rate, odds ratios were 3.9 (95% CI, 1.1-13.1) and 4.2 (95% CI, 2.2-8.1), respectively.


CONCLUSIONS
In patients with PSA level and no previous biopsy, 3-T MRI that is performed before transrectal ultrasound-guided biopsy may contribute to the detection of prostate cancer.
Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Byung Kwan
BK
Park
Jong Wook
JW
Park
Seo Yong
SY
Park
Chan Kyo
CK
Kim
Hyun Moo
HM
Lee
Seong Soo
SS
Jeon
Seong Il
SI
Seo
Byong Chang
BC
Jeong
Han Yong
HY
Choi
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000473:pathology; D020728:Transurethral Resection of Prostate
D017430:Prostate-Specific Antigen