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Repeat Targeted Prostate Biopsy under Guidance of Multiparametric MRI-Correlated Real-Time Contrast-Enhanced Ultrasound for Patients with Previous Negative Biopsy and Elevated Prostate-Specific Antigen: A Prospective Study

 Dong Ryul Jang  ;  Dae Chul Jung  ;  Young Taik Oh  ;  Songmi Noh  ;  Kyunghwa Han  ;  Kiwook Kim  ;  Koon-Ho Rha  ;  Young Deuk Choi  ;  Sung Joon Hong 
 PLOS ONE, Vol.10(6) : e0130671, 2015 
Journal Title
Issue Date
Adult ; Aged ; Biopsy, Large-Core Needle ; Contrast Media/metabolism* ; Endoscopic Ultrasound-Guided Fine Needle Aspiration/methods* ; False Negative Reactions ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging/methods* ; Male ; Middle Aged ; Neoplasm Staging ; Prognosis ; Prostate-Specific Antigen/blood* ; Prostatic Neoplasms/blood* ; Prostatic Neoplasms/metabolism ; Prostatic Neoplasms/pathology*
OBJECTIVES: To prospectively determine whether multi-parametric MRI (mpMRI) - contrast-enhanced ultrasound (CEUS) correlated, imaging-guided target biopsy (TB) method could improve the detection of prostate cancer in re-biopsy setting of patients with prior negative biopsy.
METHODS: From 2012 to 2014, a total of 42 Korean men with a negative result from previous systematic biopsy (SB) and elevated prostate-specific antigen underwent 3T mpMRI and real-time CEUS guided TB. Target lesions were determined by fusion of mpMRI and CEUS. Subsequently, 12-core SB was performed by a different radiologist. We compared core-based cancer detection rates (CaDR) using the generalized linear mixed model (GLIMMIX) for each biopsy method.
RESULTS: Core-based CaDR was higher in TB (17.92%, 38 of 212 cores) than in SB (6.15%, 31 of 504 cores) (p < 0.0001; GLIMMIX). In the cancer-positive TB cores, CaDR with suspicious lesions by mpMRI was higher than that by CEUS (86.8% vs. 60.5%, p= 0.02; paired t-test) and concordant rate between mpMRI and CEUS was significantly different with discordant rate (48% vs. 52%, p=0.04; McNemar's test).
CONCLUSION: The mpMRI-CEUS correlated TB technique for the repeat prostate biopsy of patients with prior negative biopsy can improve CaDR based on the number of cores taken.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Rha, Koon Ho(나군호) ORCID logo https://orcid.org/0000-0001-8588-7584
Oh, Young Taik(오영택) ORCID logo https://orcid.org/0000-0002-4438-8890
Jung, Dae Chul(정대철) ORCID logo https://orcid.org/0000-0001-5769-5083
Choi, Young Deuk(최영득) ORCID logo https://orcid.org/0000-0002-8545-5797
Hong, Sung Joon(홍성준) ORCID logo https://orcid.org/0000-0001-9869-065X
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