Objective: To determine the accuracy of prostate cancer detection by using magnetic resonance imaging-transrectal ultrasound (MRI-TRUS) fusion image-guided prostate biopsy.

Materials and Methods: Retrospective data were collected from the patients that underwent targeted prostate biopsy guided by MRI-TRUS fusion imaging of the prostate between January 2017 and October 2018. The data including age, serum prostate-specific antigen (PSA) levels, PSA density, prostate size, lesion size from multiparametric magnetic resonance imaging of the prostate (mpMRI), Prostate Imaging and Reporting Archiving Data System score (PI-RADS), number of targeted core biopsy, and result from the pathological diagnosis were collected. Detection rate of prostate cancer was analyzed.

Results: Ninety-five prostate cancer suspected patients underwent prostate biopsy for 143 lesions. Patients’ analyses showed better overall detection rate of prostate cancer from the MRI-TRUS fusion image-guided prostate biopsy compared to the extended 12-core systematic biopsy at 49.5% versus 17.9%. Significant prostate cancer with a Gleason score of more than 6 was detected by MRI-TRUS fusion image-guided prostate biopsy at 33.7%. Prostate cancer detection rates from MRI-TRUS fusion image-guided prostate biopsy categorized by PI-RADS score 3, 4, and 5 were 21%, 48%, and 74%, respectively, which showed statistically significant detection rate with higher PI-RADS score (p<0.001).

Conclusion: The present study showed better prostate cancer detection rate using MRI-TRUS fusion image-guide prostate biopsy with correlation to higher PI-RADS score.

Keywords: Gleason score; PI-RADS score; mpMRI; MRI-TRUS fusion image-guided prostate biopsy

DOI: doi.org/10.35755/jmedassocthai.2021.09.12702

Received 5 April 2021 | Revised 10 September 2021 | Accepted 10 September 2021