Multiparametric magnetic resonance imaging and MRI/US fusion biopsies as a method of choice for early detection of prostate cancer in biopsy-naïve men. Initial experience

At the moment the gold standard for prostate cancer (PC) diagnostics is transrectal ultrasound guided biopsy. In recent years there is a growing interest in MRI/US fusion biopsies which could increase accuracy of PC early detection. The objective was to evaluate efficacy of multiparametric magnetic resonance imaging (mpMRI) and transperineal MRI/US fusion biopsies for biopsy-naïve men who are at risk of PC and compare these results with leading research papers in the field. Retrospective - one center experience. Data gathered from year 2019 to 2020. All patients who had clinical suspicion of PC had mpMRI. Ones with PIRADS score of 3 and higher underwent transperineal MRI/US Fusion biopsy using BK Fusion technologies. All subjects where divided in 3 PIRADS groups and analyzed. Patients’ age, prostate specific antigen levels, mpMRI data (number of lesions, prostate volume) and biopsy data were analyzed. For statistical analysis IBM SPSS 22 was used. 82 biopsy naïve men were included. Average patients age was 62.8 SD ± 7.28 years, with average PSA of 9.13 ± 9.55 ng/ml and prostate volume of 50.17 ± 20.1 cm3. 53.6% (44) of patients had only one lesion, 39% (32) had two lesions. The mean number of targeted biopsies per patient was 6.87 ± 2.7. Out of all patients 59.7% (49) had PC and 25,6% (21) had clinically significant PC. In PIRADS 3 group PC was found in 28.5% (6) cases, clinically significant 16.6% (1). PIRADS 4 group 58.8 (20) of cases PC was found, clinically significant 30% (6). PIRADS 5 group 85.8% (23) had PC, clinically significant PC 60.8% (14). We concluded that as the PIRADS score increase, the detection rate of MRI/US fusion biopsies also increase. Therefore use of mpMRI and MRI/US fusion biopsies improve diagnostic accuracy. Our data is comparable to leading research in the field.