Abstract
OBJECTIVE: To evaluate the diagnostic efficacy of transrectal ultrasonography (US) bi¬opsy with imaging fusion using multiparametric (mp) magnetic resonance imaging (MRI) in patients with suspicion of prostate cancer (PCa), with an emphasis on clini¬cally significant tumors according to histological criteria. MATERIALS AND METHODS: A total of 189 consecutive US/MRI fusion biopsies were per¬formed obtaining systematic and guided samples of suspicious areas on mpMRI using a 3 Tesla magnet without endorectal coil. Clinical significance for prostate cancer was established based on Epstein criteria. RESULTS: In our casuistic, the average Gleason score was 7 and the average PSA was 5.0ng/mL. Of the 189 patients that received US/MRI biopsies, 110 (58.2%) were positive for PCa. Of those cases, 88 (80%) were clinically significant, accounting for 46.6% of all patients. We divided the MRI findings into 5 Likert scales of probability of having clinically significant PCa. The positivity of US/MRI biopsy for clinically significant PCa was 0%, 17.6% 23.5%, 53.4% and 84.4% for Likert scores 1, 2, 3, 4 and 5, respectively. There was a statistically significant difference in terms of biopsy results between dif¬ferent levels of suspicion on mpMRI and also when biopsy results were divided into groups of clinically non-significant versus clinically significant between different lev¬els of suspicion on mpMRI (p-value < 0.05 in both analyzes). CONCLUSION: We found that there is a significant difference in cancer detection using US/MRI fusion biopsy between low-probability and intermediate/high probability Likert scores using mpMRI.