title: Clinical utility of endorectal MRI-guided prostate biopsy: preliminary experience.
abstract: OBJECTIVE
  To investigate the potential clinical utility of endorectal MRI-guided biopsy in patients with known or suspected prostate cancer.
  
  
  METHODS
  We prospectively recruited 24 men with known or suspected prostate cancer in whom MRI-guided biopsy was clinically requested after multiparametric endorectal MRI showed one or more appropriate targets. One to six 18-gauge biopsy cores were obtained from each patient. Transrectal ultrasound guided biopsy results and post MRI-guided biopsy complications were also recorded.
  
  
  RESULTS
  MRI-guided biopsy was positive in 5 of 7 patients with suspected prostate cancer (including 2 of 4 with prior negative ultrasound-guided biopsies), in 8 of 12 with known untreated prostate cancer (including 5 where MRI-guided biopsy demonstrated a higher Gleason score than ultrasound guided biopsy results), and in 3 of 5 with treated cancer. MRI-guided biopsies had a significantly higher maximum percentage of cancer in positive cores when compared with ultrasound guided biopsy (mean of 37 ± 8% versus 13 ± 4%; P = 0.01). No serious postbiopsy complications occurred.
  
  
  CONCLUSIONS
  Our preliminary experience suggests endorectal MRI-guided biopsy may safely contribute to the management of patients with known or suspected prostate cancer by making a new diagnosis of malignancy, upgrading previously diagnosed disease, or diagnosing local recurrence.
authors.affiliation: Departments of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA.
authors.forename: Adam J
authors.initials: AJ
authors.lastname: Jung
authors.forename: Antonio C
authors.initials: AC
authors.lastname: Westphalen
authors.forename: John
authors.initials: J
authors.lastname: Kurhanewicz
authors.forename: Zhen J
authors.initials: ZJ
authors.lastname: Wang
authors.forename: Peter R
authors.initials: PR
authors.lastname: Carroll
authors.forename: Jeffry P
authors.initials: JP
authors.lastname: Simko
authors.forename: Fergus V
authors.initials: FV
authors.lastname: Coakley
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005240:Feasibility Studies; D006801:Humans; D061705:Image-Guided Biopsy / Q000379:methods*; D053783:Magnetic Resonance Imaging, Interventional / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011467:Prostate / Q000473:pathology*; D011471:Prostatic Neoplasms / Q000473:pathology*; D012007:Rectum; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
keywords: MR imaging; prostate biopsy; prostate cancer