Affiliation:
1. New York Presbyterian – Weil Cornell Medicine New York New York USA
2. New York Medical College New York New York USA
3. Promaxo Inc Oakland California USA
4. Mississippi Urology Jackson Mississippi USA
5. Lakeland Radiologists Jackson Mississippi USA
Abstract
AbstractObjectiveWe evaluate the clinical feasibility of a portable, low‐field magnetic resonance imaging (MRI) system for prostate cancer (PCa) biopsy.MethodsA retrospective analysis of men who underwent a 12‐core systematic transrectal ultrasound‐guided prostate biopsy (SB) and a low‐field MRI guided transperineal targeted biopsy (MRI‐TB). Comparison of the detection of clinically significant PCa (csPCa) (Gleason Grade [GG] ≥ 2) by SB and low field MRI‐TB, stratified by Prostate Imaging Reporting & Data System (PI‐RADS) score, prostate volume, and prostate serum antigen (PSA) was performed.ResultsA total of 39 men underwent both the MRI‐TB and SB biopsy. Median (interquartile range [IQR]) age was 69.0 (61.5−73) years, body mass index (BMI) was 28.9 kg/m2 (25.3–34.3), prostate volume was 46.5 cc (32−72.7), and PSA was 9.5 ng/ml (5.5−13.2). The majority (64.4%) of patients had PI‐RADS ≥ 4 lesions and 25% of lesions were anterior on pre‐biopsy MRII. Cancer detection rate (CDR) was greatest when combining SB and MRI‐TB (64.1%). MRI‐TB detected 74.3% (29/39) cancers. Of which, 53.8% (21/39) were csPCa while SB detected 42.5% (17/39) csPCa (p = 0.21). In 32.5% (13/39) of cases, MRI‐TB upstaged the final diagnosis, compared to 15% (6/39) of cases in which SB upstaged the final diagnosis (p = 0.11).ConclusionLow‐field MRI‐TB is clinically feasible. Although future studies on the accuracy of MRI‐TB system are needed, the initial CDR is comparable to those seen with fusion‐based prostate biopsies. A transperineal and targeted approach may be beneficial in patients with higher BMI and anterior lesions.
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