title: Magnetic resonance imaging-targeted vs. conventional transrectal ultrasound-guided prostate biopsy: single-institution, matched cohort comparison.
abstract: OBJECTIVE
  To compare magnetic resonance imaging-targeted biopsy (MRITB) and conventional transrectal ultrasound-guided biopsy (TRUSGB) in the detection of prostate cancer (PCa) at our institution.
  
  
  METHODS
  Our prospective registry of patients undergoing prostate MRITB from December 2010 to July 2013 was analyzed. Patients were matched one-to-one to patients who underwent TRUSGB based on the following characteristics: age, prostate-specific antigen level, prostate volume, race, family history of PCa, initial digital rectal examination (DRE), prior use of 5-alpha reductase inhibitor, and prior diagnosis of PCa. MRITB was performed using a TargetScan system with the patient under general anesthesia. Magnetic resonance imaging suspicious regions (MSRs) were targeted with cognitive registration, and a full TargetScan template biopsy (TSTB) was also performed.
  
  
  RESULTS
  In total, 34 MRITB patients were matched individually to 34 TRUSGB patients. As compared with TRUSGB, patients who underwent MRITB had a greater overall rate of PCa detection (76% vs. 56%, P = 0.12) and a significantly higher number with Gleason score≥7 (41% vs. 15%, P = 0.03), whereas the rates of Gleason score 6 PCa detection were similar between MRITB and TRUSGB (35% vs. 41%, P = 0.80). As compared with the TSTB, magnetic resonance imaging suspicious regions-directed biopsies during MRITB had a significantly higher overall PCa detection (54% vs. 24%, P<0.01) and Gleason score≥7 PCa detection (25% vs. 8%, P<0.01). When compared with TSTB, TRUSGB had similar detection rates for benign prostate tissue (76% vs. 79%, P = 0.64), Gleason score 6 PCa (16% vs. 14%, P = 0.49), and Gleason score ≥7 PCa detection (8% vs. 7%, P = 1.0).
  
  
  CONCLUSIONS
  Cognitive registration MRITB significantly improves the detection of Gleason score≥7 PCa as compared with conventional TRUSGB.
authors: Division of Urologic Surgery, Washington University School of Medicine, St. Louis, MO.
authors: Eric H
authors: EH
authors: Kim
authors: Division of Urologic Surgery, Washington University School of Medicine, St. Louis, MO.
authors: Goutham
authors: G
authors: Vemana
authors: Division of Urologic Surgery, Washington University School of Medicine, St. Louis, MO.
authors: Michael H
authors: MH
authors: Johnson
authors: Division of Urologic Surgery, Washington University School of Medicine, St. Louis, MO.
authors: Joel M
authors: JM
authors: Vetter
authors: Division of Urologic Surgery, Washington University School of Medicine, St. Louis, MO.
authors: Adam J
authors: AJ
authors: Rensing
authors: Division of Urologic Surgery, Washington University School of Medicine, St. Louis, MO.
authors: Marshall C
authors: MC
authors: Strother
authors: Department of Radiology, Washington University School of Medicine, St. Louis, MO.
authors: Kathryn J
authors: KJ
authors: Fowler
authors: Division of Urologic Surgery, Washington University School of Medicine, St. Louis, MO. Electronic address: andrioleg@wudosis.wustl.edu.
authors: Gerald L
authors: GL
authors: Andriole
mesh_terms: D000368:Aged; D001706:Biopsy / Q000379:methods*; D016022:Case-Control Studies; D051517:Digital Rectal Examination; D006801:Humans; D061705:Image-Guided Biopsy; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000378:metabolism; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging; D012042:Registries; D014463:Ultrasonography
chemical_list: D017430:Prostate-Specific Antigen
keywords: Magnetic resonance imaging; Prostate biopsy; Prostate cancer; Targeted biopsy