title: Impact of the type of ultrasound probe on prostate cancer detection rate and characterization in patients undergoing MRI-targeted prostate biopsies using cognitive fusion.
abstract: OBJECTIVE
  To assess the impact of ultrasound probe (end fire vs. side fire) during MRI-targeted prostate biopsy using cognitive fusion.
  
  
  METHODS
  Inclusion criteria were as follows: consecutive patients undergoing prostate biopsies after multiparametric MRI; no PSA above 10 ng/ml; no clinical bulking disease; MRI areas suspicious for malignancy. From January 2011 to December 2012, 91 patients were included. A standard 10 TRUS-guided biopsy protocol plus 2 targeted biopsies at any MRI lesion was used. Patient's characteristics, MRI findings, and pathology evaluations were compared between the two groups.
  
  
  RESULTS
  Mean patient age and PSA were 63 years and 5.95 ng/ml, respectively. The median number of MRI lesions was 2, and the mean volume of the index lesion was 0.64 cc. The overall PCa detection rate was 58.2 %. The MRI scoring system was significantly predictive for PCa detection and aggressiveness (p < 0.001). There was a not statistically significant trend toward greater PCa detection rate (+23 %) in the end-fire cohort (p = 0.235). The PCa detection rate is significantly improved by 1.7-fold in case of MRI score 4-5 lesion as compared to MRI score 3 lesion (p = 0.031) when using the end-fire probe. Conversely, the MRI score does not significantly influence the detection rate in the side-fire group (p = 0.250). The improvement in the PCa detection rate by the end-fire probe was predominantly reported in anterior and of apical peripheral MRI lesions.
  
  
  CONCLUSIONS
  In case of high MRI score lesions, the PCa detection rate is significantly improved when using end-firing, particularly in case of anterior and apical peripheral lesions.
authors.affiliation: Jewish General Hospital, McGill University, Pavilion E-941, 3755 Chemin de la Cote Sainte Catherine, Montreal, QC, H3T 1E2, Canada, g.ploussard@gmail.com.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Ploussard
authors.forename: Samuel
authors.initials: S
authors.lastname: Aronson
authors.forename: Vincent
authors.initials: V
authors.lastname: Pelsser
authors.forename: Mark
authors.initials: M
authors.lastname: Levental
authors.forename: Maurice
authors.initials: M
authors.lastname: Anidjar
authors.forename: Franck
authors.initials: F
authors.lastname: Bladou
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy / Q000379:methods / Q000523:psychology; D002983:Clinical Competence; D003071:Cognition; D006801:Humans; D061705:Image-Guided Biopsy; D008279:Magnetic Resonance Imaging / Q000379:methods* / Q000523:psychology; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D011467:Prostate / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D012189:Retrospective Studies; D013647:Task Performance and Analysis; D014463:Ultrasonography
chemical_list: D017430:Prostate-Specific Antigen