MRI-Guided Prostate Biopsies Have Potentially Higher Yield With Fewer Samples Interview with:

Dr. Nelly Tan MD David Geffen School of Medicine Department of Radiology UCLA

Dr. Nelly Tan

Dr. Nelly Tan MD
David Geffen School of Medicine
Department of Radiology
UCLA What is the background for this study? What are the main findings?

Dr. Tan: Standard of care for prostate cancer diagnosis has been to perform ultrasound guided random (non-targeted) prostate biopsy (TRUS) which is neither sensitive or specific. The main limitation had been our inability to detect and localize prostate cancer through imaging.

Over the past 10 years, MRI has taken center stage for detection and localization of prostate cancer and has shown to improve prostate cancer diagnosis, risk stratification, and staging of the disease. Over the past few years, MRI guided biopsy techniques (in the form of Ultrasound-MRI (US-MRI) fusion and in-bore direct MRI guided biopsy) have been reported. We reported our performance of direct in-bore MRI guided biopsy at UCLA. Our study showed a prostate cancer diagnosis of 59% in all patients and 80% of patients with prostate cancer had clinically significant cancer. What should clinicians and patients take away from your report?

Dr. Tan: Reported cancer detection rates in standard ultrasound guided random biopsy ranges from 10-30% and for US-MRI fusion ranges from 25-50%. Our study reports a prostate cancer detection rate of 59% overall is much higher. Compared to TRUS and US-MRI, which require 2 and sometimes 3 times as many samples/cores (>12 cores), MRI guided biopsy requires fewer cores, average of 5-6. Note, that this study was in patients who had clinically high suspicion for prostate cancer and thus, our study was not designed to answer the question of using MRI guided biopsy as first line for prostate cancer diagnosis. What recommendations do you have for future research as a result of this study?

Dr. Tan: This was a retrospective study without a control arm. We will need further studies evaluating direct in-bore MRI biopsy compared to US-MRI biopsy; we also need more research evaluating the cost effectiveness of MRI and whether the potentially higher diagnostic yield and fewer cores required for diagnosis of prostate cancer are cost-effective. Is there anything else you would like to add?

Dr. Tan: It’s an outstanding time for clinicians, scientists and patients. For the first time in decades, we have better ways to diagnose prostate cancer and more accurately risk stratify patients to various less-invasive therapies, which may confer better quality of life for patients and their families. Thank you for your contribution to the community.

Citation: Abstract presented at the April 2016 American Roentgen Ray Society


Predictors of Prostate Cancer During MR Biopsy

Tan N*,  Lin W,  Asvadi N,  Khoshnoodi P,  Lu D,  Raman S. University of California Los Angeles, Los Angeles, Ca

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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