Presentation Authors: Kyung Hwan Kim*, Seung Ryong Baek, Jih Hoon Park, Byeong Jin Kang, Si Kyun Park, Won Young Park, Seung Baek Hong, Suk Kim, Ja Yoon Ku, Hong Koo Ha, Busan, Korea, Republic of
Introduction: To evaluate the evidence of ultrasound-MRI fusion target biopsy on PI-RADS score 3 prostate lesions
Methods: Between October, 2016 and July, 2018, 151 patients underwent ultrasound guided systemic prostate biopsy (12 cores) and ultrasound-MRI fusion target biopsy (2 to 8 cores) concurrently. PI-RADS scores were estimated by 2 experienced uroradiologists. Patients were categorized by PI-RADS scores into 4 groups: PI-RADS score 1-2, 3, 4 and 5. We analyzed the differences of prostate cancer detection rates among 4 groups.
Results: Age, prostate volume and number of target biopsy cores showed no significant differences among 4 groups. In PI-RADS score 3 group, mean positive core numbers and rate of positive cores were lower than systemic biopsy of total cohort ( p = 0.02, 0.02, respectively). Overall cancer and clinically significant cancer detection rates of target biopsy in PI-RADS score 3 group (15.8 %, 14.0 %, respectively) were lower than systemic biopsy (43.7 %; p < 0.01, 35.1 %; p < 0.01, respectively). Overall cancer and clinically significant cancer detection rates of target biopsy on PI-RADS score 3 lesions were similar with PI-RADS score 1-2 lesions, but lower than PI-RADS score 5 lesions (74.3 %; p < 0.01, 71.4 %; p < 0.01, respectively).
Conclusions: Ultrasound-MRI fusion target biopsies on PI-RADS score 3 prostate lesions showed lower overall cancer and clinically significant cancer detection rates than systemic biopsy. There is a lack of evidence to support target biopsies on PI-RADS score 3 prostate lesions. A prospective randomized study with large sample size is needed.