Evauation of PIRADS 3 lesion with sotware fiosn biopsies

Michele Potenzoni1, Andrea Prati1, Antonio Savino1, Roberto Arnaudi1, Sergio Carmelo Destro Pastizzaro1, NIcoletta Uliano1, Annmaria PIeri1, Daniel Marten1, Federico Cantoni1, Chiara Grassani1
  • 1 Ospedale di Vaio (Fidenza)

Objective

Multiparametric Magnetic Resonance ( mpMR ) of the prostate offers the potential to improve CaP diagnosis regardless clinically significant disease. PIRADS 3 ROI has been associated with clinical significant cancer in few case and has been reported as equivocal. We evaluated retrospectively the data of patients with PIRADS 3 lesion at mpMR who underwent MR guided fusion biopsy of the prostate between August 2016 and Gennary 2017. All the immaging studies have been performed by a single radiologist expert in uro-radiology and all the biopsies have been performed by a single urologist. Data were collected in a database.
18 patients with PIRADS 3 ROI at mpMR underwent MR software guided fusion transrectal biopsy. In 17 cases the procedure have been performed under local anesthesia and in one case with general anesthesia. No complications have been reported.
Median total PSA was 6,8 mg/dl, median prostate size was 65.4 cc, median age was 68 yr . All patients received 12 core, 18 gauge needle biopsy with 2 cores for target area.
Prostate cancer has been founded in 3 (16%) patients, Gleason 6 in 1 (5,5%) patient and Gleason 7 ( 4+3 ) in 2 (11%) patients.
In our experience PIRADS 3 ROI is associated with clinical significant cancer in few cases.

Reference

Sonn GA, Natarajan S, Margolis DJA, et al: Targeted biopsy in the detection of prostate
cancer using an office based magnetic resonance ultrasound fusion device. J Urol 2013;
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Hara T, Inoue Y, Satoh T, et al: Diffusion-weighted imaging of local recurrent prostate
cancer after radiation therapy: comparison with 22-core three-dimensional prostate
mapping biopsy. Magn Reson Imaging 2012; 30: 1091–1098.

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