{Reference Type}: Journal Article
{Title}: MRI in-bore biopsy following MRI/US fusion-guided biopsy in patients with persistent suspicion of clinically significant prostate cancer.
{Author}: Quentin M;Boschheidgen M;Radtke JP;Spohn F;Ullrich T;Drewes L;Valentin B;Lakes J;Al-Monajjed ;Arsov C;Esposito I;Albers P;Antoch G;Schimmöller L;
{Journal}: Eur J Radiol
{Volume}: 175
{Issue}: 0
{Year}: 2024 Jun 21
{Factor}: 4.531
{DOI}: 10.1016/j.ejrad.2024.111436
{Abstract}: <B>OBJECTIVE: </B>Patients with suspicion of clinically significant prostate cancer (csPC) on multiparametric prostate MRI (mpMRI) but negative or inconclusive MRI/US fusion-guided biopsy (FB) can be challenging in clinical practice. To assess the utility of MRI in-bore biopsy (IB) in patients with discordant imaging and histopathological findings after FB.<BR><B>METHODS: </B>Consecutive patients with Prostate Imaging Reporting and Data System (PI-RADS) category 4 or 5 on mpMRI at 3T after FB without histologically confirmed csPC who underwent IB between 01/2014 and 05/2022, were retrospectively included. The primary objective was to assess the detection rate of csPC. Secondary objectives were to analyze clinical parameters, MRI parameters, and lesion localization.<BR><B>RESULTS: </B>In the final cohort of 51 patients, the IB resulted in an overall detection rate of 71% for PC and 47% for csPC. Furthermore, in 55% of cases with initial low-grade PC, the Gleason score was upgraded after IB. CsPC was often detected apical and/or anterior. The detection rate for PC was 58% in PI-RADS category 4 and 94% in PI-RADS category 5 (csPC 39% and 61%, respectively). Patients with csPC had statistically significant smaller prostate volumes, a higher PI-RADS category, a higher prostate-specific antigen density (PSAD), and were older.<BR><B>CONCLUSIONS: </B>For a relevant proportion of patients with PI-RADS category 4 or 5 and negative or inconclusive findings on previous FB, but with persistent suspicion of csPC, a subsequent IB verified the presence of csPC. Therefore, IB can be a backup in cases of uncertainty.