title: Comparison of re-biopsy with preceded MRI and re-biopsy without preceded MRI in patients with previous negative biopsy and persistently high PSA.
abstract: OBJECTIVE
  To retrospectively compare re-biopsy with preceded magnetic resonance imaging (MRI) and re-biopsy without preceded MRI.
  
  
  METHODS
  Between January 2007 and May 2011, 669 patients (mean 64 years; range 38-91 years) underwent a re-biopsy because of previous negative biopsy (median 1; 1-5) and persistently high prostate-specific antigen (PSA 10.6 ng/ml; 2.5-997.1 ng/ml). 3T MRI using a phased-array coil was performed in 171 (MRI group) but not in 498 (non-MRI group) prior to re-biopsy. Transrectal ultrasound-guided biopsy was performed in both MRI and non-MRI groups. MRI and non-MRI groups were compared in terms of cancer detection rate [(number of cancer-proven patients/number of patients in MRI or non-MRI group) × 100] and positive core rate [(number of cancer-positive cores/number of cores in MRI or non-MRI group) × 100] using Fisher exact test. Odds ratio and 95% confidence interval were also obtained. Pathologic diagnosis of the biopsy was considered standard reference.
  
  
  RESULTS
  Of 669 patients, 129 (19.3%) were diagnosed with adenocarcinoma. The cancer detection rates of MRI and non-MRI groups were 33.3% (57/171) and 14.5% (72/498), respectively (p < 0.001). The positive core rates of these groups were 9.2% (167/1 818) and 3.2% (179/5 631), respectively (p < 0.001). The odd ratios of cancer detection rate and positive core rate were 3.0 (95% confidence interval 2.0-4.4) and 3.1 (2.5-3.8), respectively.
  
  
  CONCLUSIONS
  Re-biopsy with preceded MRI yields higher cancer detection rate and positive core rate than re-biopsy without preceded MRI. MRI should be considered prior to re-biopsy in patients with previous negative biopsy and persistently high PSA.
authors.affiliation: The Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Byung Kwan
authors.initials: BK
authors.lastname: Park
authors.forename: Seong Soo
authors.initials: SS
authors.lastname: Jeon
authors.forename: Bumsoo
authors.initials: B
authors.lastname: Park
authors.forename: Jung Jae
authors.initials: JJ
authors.lastname: Park
authors.forename: Chan Kyo
authors.initials: CK
authors.lastname: Kim
authors.forename: Hyun Moo
authors.initials: HM
authors.lastname: Lee
authors.forename: Han Yong
authors.initials: HY
authors.lastname: Choi
mesh_terms: D000230:Adenocarcinoma / Q000097:blood / Q000473:pathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D007089:Image Enhancement; D007091:Image Processing, Computer-Assisted; D061705:Image-Guided Biopsy; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011467:Prostate / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000473:pathology*; D012189:Retrospective Studies
chemical_list: D017430:Prostate-Specific Antigen