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Rofo 2014; 186(5): 501-507
DOI: 10.1055/s-0033-1355546
Urogenital Tract
© Georg Thieme Verlag KG Stuttgart · New York

Magnetic Resonance Imaging-Guided Prostate Biopsy: Institutional Analysis and Systematic Review

Magnetresonanz gezielte Biopsie der Prostata: Institutionelle Analyse und systematischer Review
S. H. Polanec
1   Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna
,
T. H. Helbich
1   Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna
,
M. Margreiter
2   Department of Urology, Medical University of Vienna
,
H. C. Klingler
2   Department of Urology, Medical University of Vienna
,
K. Kubin
1   Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna
,
M. Susani
3   Department of Pathology, Medical University of Vienna
,
K. Pinker-Domenig
1   Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna
,
P. Brader
1   Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna
› Author Affiliations
Further Information

Publication History

08 April 2013

23 August 2013

Publication Date:
04 February 2014 (online)

Also available at
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Abstract

Objectives: To evaluate the detection rate of prostate cancer (PCa) after magnetic resonance-guided biopsy (MRGB); to monitor the patient cohort with negative MRGB results and to compare our own results with other reports in the current literature.

Materials and Methods: A group of 41 patients was included in this IRB-approved study and subjected to combined MRI and MRGB. MRGB was performed in a closed 1.5 T MR unit and the needle was inserted rectally. The follow-up period ranged between 12 and 62 months (mean 3.1 years). To compare the results with the literature, a systematic literature search was performed. Eighteen publications were evaluated.

Results: The cancer-suspicious regions were punctured successfully in all cases. PCa was detected in eleven patients (26.9 %) who were all clinically significant. MRGB showed a benign histology in the remaining 30 patients. In the follow-up (mean 3.1 years) of patients with benign histology, no new PCa was diagnosed. The missed cancer rate during follow-up was 0.0 % in our study.

Conclusion: MRGB is effective for the detection of clinically significant cancer, and this is in accordance with the recent literature. In the follow-up of patients with benign histology, no new PCa was discovered. Although the probability of developing PCa after negative MRGB is very low, active surveillance is reasonable.

Key points:

• MRGB is a reliable and safe method for the detection of PCa.

• In the follow-up of patients with benign biopsy-results, no new PCa was detected.

• Probability of detecting a cancer after negative MRGB is low.

Citation Format:

• Polanec SH, Helbich TH, Margreiter M et al. Magnetic Resonance Imaging-Guided Prostate Biopsy: Institutional Analysis and Systematic Review. Fortschr Röntgenstr 2014; 186: 501 – 507

Zusammenfassung

Ziel: Evaluierung der Detektionsrate von Prostatakarzinomen nach MR-gezielter Biopsie (MRGB); Beobachtung des Patientenkollektives mit einem negativen MRGB-Ergebnis, sowie ein Vergleich der Resultate mit der aktuellen Literatur.

Material und Methoden: Insgesamt wurden 41 Patienten mit einer kombinierten MRT und MRGB, in die von der Ethikkommission geprüfte Studie eingeschlossen. Die MRGB wurde an einem 1.5 T System durchgeführt und die Biopsienadel wurde transrektal eingeführt. Die Verlaufskontrolle der Patienten betrug zwischen 12 und 62 Monaten. Um unsere Ergebnisse mit der rezenten Literatur zu vergleichen, wurde eine systematische Literatursuche durchgeführt. Es wurden 17 Publikationen evaluiert.

Ergebnisse: Die tumorsuspekte Läsion wurde in allen Fallen erfolgreich biopsiert. Ein klinisch signifikantes PCa wurde in 11 Patienten (26,9 %) diagnostiziert. Bei den übrigen 30 Patienten zeigte sich ein gutartiges Biopsieergebnis. In der Verlaufskontrolle der Patienten mit gutartigem histologischen Befund (durchschnittlich 3,1 Jahre) wurde kein neues PCa entdeckt.

Schlussfolgerung: Die MRGB ist eine effiziente Methode zum Nachweis von klinisch signifikanten PCa und dies geht einher mit der rezenten Literatur. In der Verlaufskontrolle der Patienten mit benigner Histologie wurde kein neues PCa entdeckt. Auch wenn die Wahrscheinlichkeit eines PCa nach einer MRGB gering ist, ist die aktive Überwachung nicht außer Acht zu lassen.

Key words

prostate - biopsy - interventional MR
 

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