title: Multiparametric magnetic resonance imaging and image-guided biopsy to detect seminal vesicle invasion by prostate cancer.
abstract: OBJECTIVE
  To evaluate the correlation between multiparametric prostate MRI (MP-MRI) suspicion for seminal vesicle invasion (SVI) by prostate cancer (PCa) and pathology on MRI/ultrasound (US) fusion-guided biopsy.
  
  
  METHODS
  From March 2007 to June 2013, 822 patients underwent MP-MRI at 3 Tesla and MRI/US fusion-guided biopsy. Of these, 25 patients underwent targeted biopsy of the seminal vesicles (SVs). In six patients, bilateral SVI was suspected, resulting in 31 samples. MP-MRI findings that triggered these SV biopsies were scored as low, moderate, or high suspicion for SVI based on the degree of involvement on MRI. Correlative prostate biopsy and radical prostatectomy (RP) pathology were reviewed by a single genitourinary pathologist.
  
  
  RESULTS
  At the time of MP-MRI, the median age was 64 years with a median prostate-specific antigen of 10.74 ng/mL. Of the 31 SV lesions identified, MP-MRI suspicion scores of low, moderate, and high were assigned to 3, 19, and 9 lesions, respectively. MRI/US fusion-guided biopsy detected SVI in 20/31 (65%) of cases. For the four patients who underwent RP after a preoperative assessment of SVI, biopsy pathology and RP pathology were concordant in all cases.
  
  
  CONCLUSIONS
  As this technology becomes more available, MP-MRI and MRI/US fusion-guided biopsy may play a role in the preoperative staging for PCa. Future work will determine if improved preoperative staging leads to better surgical outcomes.
authors.affiliation: 1 Urologic Oncology Branch, National Cancer Institute, National Institutes of Health , Bethesda, Maryland.
authors.forename: Dima
authors.initials: D
authors.lastname: Raskolnikov
authors.forename: Arvin K
authors.initials: AK
authors.lastname: George
authors.forename: Soroush
authors.initials: S
authors.lastname: Rais-Bahrami
authors.forename: Baris
authors.initials: B
authors.lastname: Turkbey
authors.forename: Nabeel A
authors.initials: NA
authors.lastname: Shakir
authors.forename: Chinonyerem
authors.initials: C
authors.lastname: Okoro
authors.forename: Jason T
authors.initials: JT
authors.lastname: Rothwax
authors.forename: Annerleim
authors.initials: A
authors.lastname: Walton-Diaz
authors.forename: M Minhaj
authors.initials: MM
authors.lastname: Siddiqui
authors.forename: Daniel
authors.initials: D
authors.lastname: Su
authors.forename: Lambros
authors.initials: L
authors.lastname: Stamatakis
authors.forename: Maria J
authors.initials: MJ
authors.lastname: Merino
authors.forename: Bradford J
authors.initials: BJ
authors.lastname: Wood
authors.forename: Peter L
authors.initials: PL
authors.lastname: Choyke
authors.forename: Peter A
authors.initials: PA
authors.lastname: Pinto
mesh_terms: D000368:Aged; D006801:Humans; D061705:Image-Guided Biopsy; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000473:pathology*; D012669:Seminal Vesicles / Q000473:pathology*