title: Repeat Targeted Prostate Biopsy under Guidance of Multiparametric MRI-Correlated Real-Time Contrast-Enhanced Ultrasound for Patients with Previous Negative Biopsy and Elevated Prostate-Specific Antigen: A Prospective Study.
abstract: OBJECTIVE
  To prospectively determine whether multi-parametric MRI (mpMRI) - contrast-enhanced ultrasound (CEUS) correlated, imaging-guided target biopsy (TB) method could improve the detection of prostate cancer in re-biopsy setting of patients with prior negative biopsy.
  
  
  METHODS
  From 2012 to 2014, a total of 42 Korean men with a negative result from previous systematic biopsy (SB) and elevated prostate-specific antigen underwent 3T mpMRI and real-time CEUS guided TB. Target lesions were determined by fusion of mpMRI and CEUS. Subsequently, 12-core SB was performed by a different radiologist. We compared core-based cancer detection rates (CaDR) using the generalized linear mixed model (GLIMMIX) for each biopsy method.
  
  
  RESULTS
  Core-based CaDR was higher in TB (17.92%, 38 of 212 cores) than in SB (6.15%, 31 of 504 cores) (p < 0.0001; GLIMMIX). In the cancer-positive TB cores, CaDR with suspicious lesions by mpMRI was higher than that by CEUS (86.8% vs. 60.5%, p= 0.02; paired t-test) and concordant rate between mpMRI and CEUS was significantly different with discordant rate (48% vs. 52%, p=0.04; McNemar's test).
  
  
  CONCLUSIONS
  The mpMRI-CEUS correlated TB technique for the repeat prostate biopsy of patients with prior negative biopsy can improve CaDR based on the number of cores taken.
authors.affiliation: Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Dong Ryul
authors.initials: DR
authors.lastname: Jang
authors.affiliation: Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Dae Chul
authors.initials: DC
authors.lastname: Jung
authors.affiliation: Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Young Taik
authors.initials: YT
authors.lastname: Oh
authors.affiliation: Department of Pathology, Cha Medical College, Gang-Nam Cha Hospital, Seoul, Republic of Korea.
authors.forename: Songmi
authors.initials: S
authors.lastname: Noh
authors.affiliation: Avison Biomedical Research Center; Department of Radiology; Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Kyunghwa
authors.initials: K
authors.lastname: Han
authors.affiliation: Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Kiwook
authors.initials: K
authors.lastname: Kim
authors.affiliation: Department of Urology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Koon-Ho
authors.initials: KH
authors.lastname: Rha
authors.affiliation: Department of Urology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Young Deuk
authors.initials: YD
authors.lastname: Choi
authors.affiliation: Department of Urology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Sung Joon
authors.initials: SJ
authors.lastname: Hong
mesh_terms: D000328:Adult; D000368:Aged; D062005:Biopsy, Large-Core Needle; D003287:Contrast Media / Q000378:metabolism*; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000379:methods*; D005188:False Negative Reactions; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood* / Q000378:metabolism / Q000473:pathology*
chemical_list: D003287:Contrast Media; D017430:Prostate-Specific Antigen