title: First round of targeted biopsies using magnetic resonance imaging/ultrasonography fusion compared with conventional transrectal ultrasonography-guided biopsies for the diagnosis of localised prostate cancer.
abstract: OBJECTIVE
  To assess the accuracy of magnetic resonance imaging (MRI)/transrectal ultrasonography (TRUS) fusion to guide first-round biopsies in the diagnosis of localised prostate cancer (PCa) in men with a prostate-specific antigen (PSA) ≤10 ng/mL.
  
  
  METHODS
  A prospective study was conducted on men who met the following criteria: first-round biopsy, multiparametric MRI (mpMRI) showing a lesion with a Likert score ≥2 and a PSA <10 ng/mL. All men underwent a extended 12-core protocol plus a protocol of two or three targeted cores on the mpMRI index lesion. The UroStation (Koelis, Grenoble, France) and a V10 ultrasound system with an end-fire three-dimensional TRUS transducer were used for the fusion imaging procedure. Significant PCa was defined as: at least one core with a Gleason score of 3 + 4 or 6 with a maximum cancer core length ≥4 mm.
  
  
  RESULTS
  A total of 152 men, whose median PSA level was 6 ng/mL, were included in the study. The proportion of positive cores was significantly higher with the targeted-core protocol than with the extended 12-core protocol (P < 0.001). The proportion of men with clinically significant PCa was higher with the targeted-core protocol than with the extended 12-core protocol (P = 0.03). The proportion of patients having at least one positive biopsy (targeted-core protocol) was significantly different among the Likert score categories (P < 0.001).
  
  
  CONCLUSIONS
  For the first round of biopsies, MRI/TRUS-fusion targeted biopsies detected more men with clinically significant PCa than did standard extended 12-core biopsy alone.
authors.affiliation: Academic Department of Urology, AP-HP, Hopital Pitié-Salpétrière, Paris, France; UPMC University of Paris 06, Institut des Systèmes Intelligents et de Robotique.
authors.forename: Pierre
authors.initials: P
authors.lastname: Mozer
authors.forename: Morgan
authors.initials: M
authors.lastname: Rouprêt
authors.forename: Chloé
authors.initials: C
authors.lastname: Le Cossec
authors.forename: Benjamin
authors.initials: B
authors.lastname: Granger
authors.forename: Eva
authors.initials: E
authors.lastname: Comperat
authors.forename: Arachk
authors.initials: A
authors.lastname: de Gorski
authors.forename: Olivier
authors.initials: O
authors.lastname: Cussenot
authors.forename: Raphaële
authors.initials: R
authors.lastname: Renard-Penna
mesh_terms: D000368:Aged; D006801:Humans; D061705:Image-Guided Biopsy / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D018084:Ultrasonography, Interventional / Q000379:methods*
keywords: Gleason score; MRI; biopsy; prostate neoplasms; prostate-specific antigen