title: MRI-guided core needle biopsy of the prostate: acceptance and side effects.
abstract: OBJECTIVE
  We aimed to study side effects, complications, and patient acceptance of magnetic resonance imaging-guided real-time biopsy (MRI-GB) of the prostate.
  
  
  METHODS
  Fifty-four men (49-78 years) with elevated prostate-specific antigen after at least one negative systematic transrectal ultrasound-guided biopsy (TRUS-GB) were included in a prospective clinical study. Suspicious areas on images were selectively sampled by obtaining a median of four specimens (range, 1-9 specimens) using MRI-GB. In TRUS-GB, a median of 10 specimens (range, 6-14 specimens) were obtained. Telephone interviews were conducted one week after outpatient MRI-GB, asking patients about pain and side effects (hematuria, hemospermia, rectal bleeding, fever, and chills) of the two biopsy procedures and which of the two procedures they preferred. Multinomial regression analysis and Fisher's exact test was used to test for differences.
  
  
  RESULTS
  MRI-GB was preferred by 65% (35/54), and 82% (44/54) would undergo MRI-GB again. Pain intensity (P = 0.005) and bleeding duration (P = 0.004) were significantly lower for MRI-GB compared with TRUS-GB. Hematuria was less common after MRI-GB compared with TRUS-GB (P = 0.006). A high correlation was given between bleeding intensity and bleeding duration for TRUS-GB (r=0.77) and pain intensity and pain duration for MRI-GB (r=0.65). Although hemospermia, rectal hemorrhage, fever, and chills were less common in MRI, they showed no statistically significant difference.
  
  
  CONCLUSIONS
  MRI-GB of the prostate seems to have fewer side effects and less pain intensity than TRUS-GB and was preferred by the majority of patients.
authors: Center of Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany. tobias.franiel@med.uni-jena.de.
authors: Nina
authors: N
authors: Egbers
authors: Carsten
authors: C
authors: Schwenke
authors: Andreas
authors: A
authors: Maxeiner
authors: Ulf
authors: U
authors: Teichgräber
authors: Tobias
authors: T
authors: Franiel
mesh_terms: D000368:Aged; D062005:Biopsy, Large-Core Needle / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D061705:Image-Guided Biopsy / Q000009:adverse effects / Q000379:methods*; D007610:Kallikreins / Q000097:blood; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D057240:Patient Preference; D011446:Prospective Studies; D011467:Prostate / Q000000981:diagnostic imaging / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000000981:diagnostic imaging / Q000473:pathology*; D012044:Regression Analysis; D011795:Surveys and Questionnaires; D018084:Ultrasonography, Interventional / Q000009:adverse effects / Q000379:methods
chemical_list: C549870:KLK3 protein, human; D007610:Kallikreins; D017430:Prostate-Specific Antigen