Value of Systematic and MRI‐Ultrasound Fusion Prostate Biopsy in Different Prostate Specific Antigen (PSA) Levels

• Published in: Cancer reports Vol. 8; no. 1; pp. e70099 - n/a
• Main Authors: Ohadian Moghadam, Solmaz, Haddadi, Mohammad, Amini, Erfan, Momeni, Seyed Ali, Bitaraf, Masoud, Nowroozi, Mohammad Reza
• Format: Journal Article
• Language: English
• Published: United States John Wiley and Sons Inc 01.01.2025; Wiley
• Subjects: Aged; fusion biopsy; Humans; Image-Guided Biopsy - methods; Kallikreins - blood; Magnetic Resonance Imaging - methods; Male; Middle Aged; MRI‐targeted biopsy; Original; Prostate - diagnostic imaging; Prostate - pathology; prostate cancer; prostate specific antigen; Prostate-Specific Antigen - blood; Prostatic Neoplasms - blood; Prostatic Neoplasms - diagnosis; Prostatic Neoplasms - diagnostic imaging; Prostatic Neoplasms - pathology; PSA; Retrospective Studies; transrectal biopsy; Ultrasonography - methods; prostate specific antigen; prostate cancer; MRI‐targeted biopsy; fusion biopsy; transrectal biopsy; PSA
• ISSN: 2573-8348; 2573-8348
• DOI: 10.1002/cnr2.70099

ABSTRACT Background Current approach to clinically suspicious biopsy‐naïve men consists performing prostate MRI, followed by combined systematic (TRUS‐Bx) and MRI‐Ultrasound fusion biopsy (MRI‐TBx) in those with PIRADS score ≥ 3. Researchers have attempted to determine who benefits from each biopsy method, but the results do not support the safe use of one method alone. This study aims to determine the optimal approach in biopsy‐naïve men, according to their PSA levels. Methods and Results A retrospective chart review of clinically suspicious biopsy‐naïve men who underwent both TRUS‐Bx and MRI‐TBx was done. Prostate specific antigen (PSA) levels were compared between patients only positive for MRI‐TBx and those with positive TRUS‐Bx. Further, cancer cases were divided to < 10 and ≥ 10 PSA groups and the pathology results, obtained by each method, were compared. Out of 195 men, 36 were diagnosed with prostate cancer (PCa). PCa was diagnosed by both MRI‐TBx and TRUS‐Bx in 26 men, half of whom had PSA > 10 ng/mL. At PSA ≤ 10 ng/mL, PCa would have been missed in 4 men (11.1%) had MRI‐TBx not been done, and in 6 men (16.6%) had TRUS‐Bx not been done. Conclusion Despite attempts to perform only one biopsy method in men with clinical suspicion of prostate cancer, we propose that at least in men with PSA ≤ 10 ng/mL, both systematic and MRI‐targeted biopsies be performed.