title: Pathologic correlation of transperineal in-bore 3-Tesla magnetic resonance imaging-guided prostate biopsy samples with radical prostatectomy specimen.
abstract: To determine the accuracy of in-bore transperineal 3-Tesla (T) magnetic resonance (MR) imaging-guided prostate biopsies for predicting final Gleason grades in patients who subsequently underwent radical prostatectomy (RP).
  
  
  
  A retrospective review of men who underwent transperineal MR imaging-guided prostate biopsy (tpMRGB) with subsequent radical prostatectomy within 1 year was conducted from 2010 to 2015. All patients underwent a baseline 3-T multiparametric MRI (mpMRI) with endorectal coil and were selected for biopsy based on MR findings of a suspicious prostate lesion and high degree of clinical suspicion for cancer. Spearman correlation was performed to assess concordance between tpMRGB and final RP pathology among patients with and without previous transrectal ultrasound (TRUS)-guided biopsies.
  
  
  
  A total of 24 men met all eligibility requirements, with a median age of 65 years (interquartile range [IQR] 11.7). The median time from biopsy to RP was 85 days (IQR 50.5). Final pathology revealed Gleason 3 + 4 = 7 in 12 patients, 4 + 3 = 7 in 10 patients, and 4 + 4 = 8 in 2 patients. A strong correlation (ρ: +0.75, p < 0.001) between tpMRGB and RP results was observed, with Gleason scores concordant in 17 cases (71%). 16 of the 24 patients underwent prior TRUS biopsies. Subsequent tpMRGB revealed Gleason upgrading in 88% of cases, which was concordant with RP Gleason scores in 69% of cases (ρ: +0.75, p < 0.001).
  
  
  
  Final Gleason scores diagnosed by tpMRGB at 3-T correlate strongly with final RP surgical pathology. This may facilitate prostate cancer diagnosis, particularly in patients with negative or low-grade TRUS biopsy results in whom clinically significant cancer is suspected or detected on mpMRI.
authors.affiliation: Department of Radiology, Harvard Medical School, Brigham and Women's Hospital, National Center for Image Guided Therapy, 75 Francis St, Boston, MA, 02115, USA. Erik.velez117@gmail.com.
authors.forename: Erik
authors.initials: E
authors.lastname: Velez
authors.affiliation: Department of Radiology, Harvard Medical School, Brigham and Women's Hospital, National Center for Image Guided Therapy, 75 Francis St, Boston, MA, 02115, USA.
authors.forename: Andriy
authors.initials: A
authors.lastname: Fedorov
authors.affiliation: Department of Radiology, Harvard Medical School, Brigham and Women's Hospital, National Center for Image Guided Therapy, 75 Francis St, Boston, MA, 02115, USA.
authors.forename: Kemal
authors.initials: K
authors.lastname: Tuncali
authors.affiliation: Department of Radiology, Harvard Medical School, Brigham and Women's Hospital, National Center for Image Guided Therapy, 75 Francis St, Boston, MA, 02115, USA.
authors.forename: Olutayo
authors.initials: O
authors.lastname: Olubiyi
authors.affiliation: Division of Urology, Department of Surgery, Harvard Medical School, Brigham and Women's Hospital, 75 Francis St, Boston, MA, 02115, USA.
authors.forename: Christopher B
authors.initials: CB
authors.lastname: Allard
authors.affiliation: Division of Urology, Department of Surgery, Harvard Medical School, Brigham and Women's Hospital, 75 Francis St, Boston, MA, 02115, USA.
authors.forename: Adam S
authors.initials: AS
authors.lastname: Kibel
authors.affiliation: Department of Radiology, Harvard Medical School, Brigham and Women's Hospital, National Center for Image Guided Therapy, 75 Francis St, Boston, MA, 02115, USA.
authors.forename: Clare M
authors.initials: CM
authors.lastname: Tempany
mesh_terms: D000368:Aged; D006801:Humans; D061705:Image-Guided Biopsy; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D060787:Neoplasm Grading; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000601:surgery*; D012189:Retrospective Studies
keywords: MRI-guided prostate biopsy; Prostate cancer