title: Multiparametric Prostate Magnetic Resonance Imaging and Cognitively Targeted Transperineal Biopsy in Patients With Previous Abdominoperineal Resection and Suspicion of Prostate Cancer.
abstract: OBJECTIVE
  To report our experience with a combination of prostate magnetic resonance imaging (MRI) and transperineal ultrasound biopsy for evaluating the prostate in patients with elevated prostate-specific antigen (PSA) who have previously undergone abdominoperineal resection (APR).
  
  
  METHODS
  We reviewed the records of 11 patients with a history of APR and clinical suspicion of prostate cancer due to elevated PSA levels over a 5-year period. All patients underwent multiparametric MRI at our institution prior to biopsy. MR diagnoses were validated either by transperineal ultrasound biopsy (Likert 3-5) guided by visual registration or clinical follow-up >6 months (Likert 1-2).
  
  
  RESULTS
  All 7 cases with highly suspicious lesions (Likert 4-5) on MRI demonstrated cancer-1 case of Gleason 3 + 3 and 6 cases of Gleason ≥3 + 4 disease. Two cases with Likert 3 MR lesions revealed benign tissue upon biopsy. Two patients with no suspicious lesions on MRI were followed-up clinically, with PSA levels remaining stable over a mean period of 17.5 months (range 7-28 months).
  
  
  CONCLUSIONS
  The use of prebiopsy multiparametric prostate MRI and subsequent cognitively targeted transperineal biopsy guided by visual registration can aid in the diagnostic pathway of patients with APR and a suspicion of prostate cancer.
authors.affiliation: Department of Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Aachen, Germany; CamPARI Clinic, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK.
authors.forename: Nienke L
authors.initials: NL
authors.lastname: Hansen
authors.affiliation: CamPARI Clinic, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK; Department of Radiology, University Medical Centre Maribor, Maribor, Slovenia.
authors.forename: Iztok
authors.initials: I
authors.lastname: Caglic
authors.affiliation: CamPARI Clinic, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK; Department of Radiology, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK.
authors.forename: Laurence H
authors.initials: LH
authors.lastname: Berman
authors.affiliation: CamPARI Clinic, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK; Department of Urology, Addenbrooke's Hospital, Cambridge, UK.
authors.forename: Christof
authors.initials: C
authors.lastname: Kastner
authors.affiliation: CamPARI Clinic, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK; Department of Urology, Addenbrooke's Hospital, Cambridge, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Doble
authors.affiliation: CamPARI Clinic, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK; Department of Radiology, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK. Electronic address: Tristan.barrett@addenbrookes.nhs.uk.
authors.forename: Tristan
authors.initials: T
authors.lastname: Barrett
mesh_terms: D000005:Abdomen / Q000601:surgery; D000368:Aged; D001707:Biopsy, Needle / Q000379:methods; D006801:Humans; D061705:Image-Guided Biopsy; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D010502:Perineum / Q000601:surgery; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D012189:Retrospective Studies; D014463:Ultrasonography