title: Prostate cancer detection using multiparametric 3 - tesla MRI and fusion biopsy: preliminary results.
abstract: OBJECTIVE
  To evaluate the diagnostic efficacy of transrectal ultrasonography (US) bi¬opsy with imaging fusion using multiparametric (mp) magnetic resonance imaging (MRI) in patients with suspicion of prostate cancer (PCa), with an emphasis on clini¬cally significant tumors according to histological criteria.
  
  
  METHODS
  A total of 189 consecutive US/MRI fusion biopsies were per¬formed obtaining systematic and guided samples of suspicious areas on mpMRI using a 3 Tesla magnet without endorectal coil. Clinical significance for prostate cancer was established based on Epstein criteria.
  
  
  RESULTS
  In our casuistic, the average Gleason score was 7 and the average PSA was 5.0ng/mL. Of the 189 patients that received US/MRI biopsies, 110 (58.2%) were positive for PCa. Of those cases, 88 (80%) were clinically significant, accounting for 46.6% of all patients. We divided the MRI findings into 5 Likert scales of probability of having clinically significant PCa. The positivity of US/MRI biopsy for clinically significant PCa was 0%, 17.6% 23.5%, 53.4% and 84.4% for Likert scores 1, 2, 3, 4 and 5, respectively. There was a statistically significant difference in terms of biopsy results between dif¬ferent levels of suspicion on mpMRI and also when biopsy results were divided into groups of clinically non-significant versus clinically significant between different lev¬els of suspicion on mpMRI (p-value < 0.05 in both analyzes).
  
  
  CONCLUSIONS
  We found that there is a significant difference in cancer detection using US/MRI fusion biopsy between low-probability and intermediate/high probability Likert scores using mpMRI.
authors.affiliation: Departamento de Radiologia e Diagnóstico por Imagem do Hospital Israelita Albert Einstein, São Paulo, SP, Brasil.
authors.forename: Thais Caldara
authors.initials: TC
authors.lastname: Mussi
authors.affiliation: Departamento de Intervenção Guiada por Imagem do Hospital Israelita Albert Einstein, São Paulo, SP, Brasil.
authors.forename: Rodrigo Gobbo
authors.initials: RG
authors.lastname: Garcia
authors.affiliation: Departamento de Intervenção Guiada por Imagem do Hospital Israelita Albert Einstein, São Paulo, SP, Brasil.
authors.forename: Marcos Roberto Gomes
authors.initials: MR
authors.lastname: Queiroz
authors.affiliation: Departamento de Urologia do Hospital Israelita Albert Einstein, São Paulo, SP, Brasil.
authors.forename: Gustavo Caserta
authors.initials: GC
authors.lastname: Lemos
authors.affiliation: Departamento de Radiologia e Diagnóstico por Imagem do Hospital Israelita Albert Einstein, São Paulo, SP, Brasil.
authors.forename: Ronaldo Hueb
authors.initials: RH
authors.lastname: Baroni
mesh_terms: D000368:Aged; D006801:Humans; D061705:Image-Guided Biopsy / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000295:instrumentation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D011237:Predictive Value of Tests; D011467:Prostate / Q000000981:diagnostic imaging / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D018084:Ultrasonography, Interventional / Q000379:methods
chemical_list: D017430:Prostate-Specific Antigen
keywords: Magnetic Resonance Imaging; Prostate; Prostatic Neoplasms