title: Combination of multiparametric MRI and transperineal template-guided mapping biopsy of the prostate to identify candidates for hemi-ablative focal therapy.
abstract: OBJECTIVE
  To evaluate the accuracy of combined multiparametric magnetic resonance imaging (mpMRI) and transperineal template-guided mapping biopsy (TTMB) for identifying lobes with significant prostate cancer (PCa) for the application of hemi-ablative focal therapy (FT).
  
  
  METHODS
  From January 2012 to January 2014, 89 consecutive patients, aged ≥40 years, with a PSA level ≤15 ng/mL, underwent in sequential order: mpMRI, TTMB and radical prostatectomy (RP) at a single centre. Analysis was performed on 50 patients who met consensus guidelines for FT. Lobes were stratified into lobes with significant cancer (LSC), lobes with insignificant cancer and lobes with no cancer. Using histopathology at RP, the predictive performance of combined mpMRI + TTMB in identifying LSC was evaluated.
  
  
  RESULTS
  The sensitivity, specificity and positive predictive value for mpMRI + TTMB for LSC were 97, 61 and 83%, respectively. The negative predictive value (NPV), the primary variable of interest, for mpMRI + TTMB for LSC was 91%. Of the 50 patients, 21 had significant unilateral disease on mpMRI + TTMB. Two of these 21 patients had significant bilateral disease on RP not identified on mpMRI + TTMB.
  
  
  CONCLUSIONS
  In the selection of candidates for FT, a combination of mpMRI and TTMB provides a high NPV in the detection of LSC.
authors: St Vincent's Prostate Cancer Centre, Darlinghurst, NSW, Australia.|Garvan Institute of Medical Research & The Kinghorn Cancer Centre, Darlinghurst, NSW, Australia.|School of Medicine, University of Sydney, Sydney, NSW, Australia.
authors: Minh
authors: M
authors: Tran
authors: St Vincent's Prostate Cancer Centre, Darlinghurst, NSW, Australia.|Garvan Institute of Medical Research & The Kinghorn Cancer Centre, Darlinghurst, NSW, Australia.|School of Medicine, University of New South Wales, Sydney, NSW, Australia.
authors: James
authors: J
authors: Thompson
authors: Garvan Institute of Medical Research & The Kinghorn Cancer Centre, Darlinghurst, NSW, Australia.
authors: Maret
authors: M
authors: Böhm
authors: Garvan Institute of Medical Research & The Kinghorn Cancer Centre, Darlinghurst, NSW, Australia.
authors: Marley
authors: M
authors: Pulbrook
authors: Spectrum Medical Imaging, Randwick, NSW, Australia.
authors: Daniel
authors: D
authors: Moses
authors: Southern Radiology, Randwick, NSW, Australia.
authors: Ron
authors: R
authors: Shnier
authors: St Vincent's Prostate Cancer Centre, Darlinghurst, NSW, Australia.|Garvan Institute of Medical Research & The Kinghorn Cancer Centre, Darlinghurst, NSW, Australia.|School of Medicine, University of New South Wales, Sydney, NSW, Australia.
authors: Phillip
authors: P
authors: Brenner
authors: Douglass Hanly Moir Pathology, Darlinghurst, NSW, Australia.
authors: Warick
authors: W
authors: Delprado
authors: Garvan Institute of Medical Research & The Kinghorn Cancer Centre, Darlinghurst, NSW, Australia.
authors: Anne-Maree
authors: AM
authors: Haynes
authors: School of Medicine, University of New South Wales, Sydney, NSW, Australia.
authors: Richard
authors: R
authors: Savdie
authors: St Vincent's Prostate Cancer Centre, Darlinghurst, NSW, Australia.|Garvan Institute of Medical Research & The Kinghorn Cancer Centre, Darlinghurst, NSW, Australia.|School of Medicine, University of New South Wales, Sydney, NSW, Australia.
authors: Phillip D
authors: PD
authors: Stricker
mesh_terms: D001706:Biopsy / Q000379:methods*; D003936:Diagnosis, Computer-Assisted; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D011467:Prostate / Q000473:pathology*; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000473:pathology*; D012680:Sensitivity and Specificity
keywords: MRI; focal therapy; prostate cancer; transperineal template-guided mapping biopsy