title: Targeted Prostate Biopsy: Lessons Learned Midst the Evolution of a Disruptive Technology.
abstract: Lessons learned during a 6-year experience with more than 1200 patients undergoing targeted prostate biopsy via MRI/ultrasound fusion are reported: (1) the procedure is safe and efficient, requiring some 15-20 minutes in an office setting; (2) MRI is best performed by a radiologist with specialized training, using a transabdominal multiparametric approach and preferably a 3T magnet; (3) grade of MRI suspicion is the most powerful predictor of biopsy results, eg, Grade 5 usually represents cancer; (4) some potentially important cancers (15%-30%) are MRI-invisible; (5) Targeted biopsies provide >80% concordance with whole-organ pathology. Early enthusiasm notwithstanding, cost-effectiveness is yet to be resolved, and the technologies remain in evolution.
authors.affiliation: Department of Urology, University of California at Los Angeles, Los Angeles, CA.
authors.forename: Nima
authors.initials: N
authors.lastname: Nassiri
authors.affiliation: Department of Urology, University of California at Los Angeles, Los Angeles, CA; Departments of Urology and Biomedical Engineering, University of California at Los Angeles, Los Angeles, CA.
authors.forename: Shyam
authors.initials: S
authors.lastname: Natarajan
authors.affiliation: Department of Radiology, University of California at Los Angeles, Los Angeles, CA.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Margolis
authors.affiliation: Department of Urology, University of California at Los Angeles, Los Angeles, CA. Electronic address: Lmarks@mednet.ucla.edu.
authors.forename: Leonard S
authors.initials: LS
authors.lastname: Marks
mesh_terms: D004059:Diffusion of Innovation; D006801:Humans; D061705:Image-Guided Biopsy / Q000295:instrumentation*; D008279:Magnetic Resonance Imaging / Q000295:instrumentation*; D008297:Male; D011471:Prostatic Neoplasms / Q000473:pathology*; D012680:Sensitivity and Specificity