title: Detection of prostate cancer using magnetic resonance imaging/ultrasonography image-fusion targeted biopsy in African-American men.
abstract: To assess the diagnostic yield of targeted prostate biopsy in African-American (A-A) men using image fusion of multi-parametric magnetic resonance imaging (mpMRI) with real-time transrectal ultrasonography (US).
  
  
  
  We retrospectively analysed 661 patients (117 A-A and 544 Caucasian) who had mpMRI before biopsy and then underwent MRI/US image-fusion targeted biopsy (FTB) between October 2012 and August 2015. The mpMRIs were reported on a 5-point Likert scale of suspicion. Clinically significant prostate cancer (CSPC) was defined as biopsy Gleason score ≥7.
  
  
  
  After controlling for age, prostate-specific antigen level and prostate volume, there were no significant differences between A-A and Caucasian men in the detection rate of overall cancer (35.0% vs 34.2%, P = 0.9) and CSPC (18.8% vs 21.7%, P = 0.3) with MRI/US FTB. There were no significant differences between the races in the location of dominant lesions on mpMRI, and in the proportion of 5-point Likert scoring. In A-A men, MRI/US FTB from the grade 4-5 lesions outperformed random biopsy in the detection rate of overall cancer (70.6% vs 37.2%, P = 0.003) and CSPC (52.9% vs 12.4%, P < 0.001). MRI/US FTB outperformed random biopsy in cancer core length (5.0 vs 2.4 mm, P = 0.001), in cancer rate per core (24.9% vs 6.8%, P < 0.001), and in efficiency for detecting one patient with CSPC (mean number of cores needed 13.3 vs 81.9, P < 0.001), respectively.
  
  
  
  Our key finding confirms a lack of racial difference in the detection rate of overall prostate cancers and CSPC with MRI/US FTB between A-A and Caucasian men. MRI/US FTB detected more CSPC using fewer cores compared with random biopsy.
authors.affiliation: USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.|Department of Urology, Oita University, Oita, Japan.
authors.forename: Toshitaka
authors.initials: T
authors.lastname: Shin
authors.affiliation: Chesapeake Urology Associates, Owings Mills, MD, USA.
authors.forename: Thomas B
authors.initials: TB
authors.lastname: Smyth
authors.affiliation: USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.|Department of Urology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Ukimura
authors.affiliation: USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
authors.forename: Nariman
authors.initials: N
authors.lastname: Ahmadi
authors.affiliation: USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
authors.forename: Andre Luis
authors.initials: AL
authors.lastname: de Castro Abreu
authors.affiliation: USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.|Department of Urology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Masakatsu
authors.initials: M
authors.lastname: Oishi
authors.affiliation: Department of Urology, Oita University, Oita, Japan.
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Mimata
authors.affiliation: USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
authors.forename: Inderbir S
authors.initials: IS
authors.lastname: Gill
mesh_terms: D000328:Adult; D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D019160:Endosonography; D006801:Humans; D061705:Image-Guided Biopsy / Q000379:methods*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging / Q000208:ethnology* / Q000473:pathology*; D012189:Retrospective Studies
chemical_list: D017430:Prostate-Specific Antigen
keywords: 
  MRI
  ; African-American; Likert scoring system; MRI/US image-fusion targeted biopsy; prostate cancer