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open access

Vol 73, No 4 (2022)
Original paper
Submitted: 2022-01-13
Accepted: 2022-03-24
Published online: 2022-07-18
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In-bore MR prostate biopsy — initial experience

Justyna Rembak-Szynkiewicz1, Piotr Wojcieszek2, Anna Hebda1, Patrycja Mazgaj1, Arkadiusz Badziński34, Gabriela Stasik-Pres1, Ewa Chmielik5, Barbara Bobek-Billewicz1
DOI: 10.5603/EP.a2022.0042
·
Pubmed: 35971938
·
Endokrynol Pol 2022;73(4):712-724.
Affiliations
  1. Radiology and Diagnostic Imaging Department, Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice Branch, Poland
  2. Brachytherapy Department, Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice Branch, Poland
  3. Department of Histology and Cell Pathology, Medical University of Silesia, Katowice, Poland
  4. Institute of Linguistics, University of Silesia, Katowice, Poland
  5. Tumor Pathology Department, Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice Branch, Poland

open access

Vol 73, No 4 (2022)
Original Paper
Submitted: 2022-01-13
Accepted: 2022-03-24
Published online: 2022-07-18

Abstract

Introduction: The introduction of multiparametric MRI (mpMRI) has been a breakthrough in the diagnosis of noninvasive clinically significant prostate cancer. Currently, MR-guided prostate biopsy (in-bore biopsy) is the only biopsy method that uses real-time MRI in patients with suspected prostate cancer. The aim of the study was a retrospective analysis of the correlation between MRI results and histological findings of prostate samples suspected of malignancy, which were taken during MRI-guided biopsy.

Material and methods: Thirty-nine patients with 57 lesion biopsies were enrolled in the study. Patients were aged 48–84 years (mean age 67.2 ± 9.4 years).

Results: Cancer was histologically confirmed in 24 lesions, including primary cancer in 14 lesions and local recurrence in 10 lesions. Cancer was not detected in the remaining lesions (n = 33). Malignancy was confirmed in 90% of lesions previously reported as PI-RADS 5. Only one Prostate Imaging and Reporting and Data System (PI-RADS 5) lesion was histologically negative (prostatitis). Cancer was detected in 50% of lesions defined as PI-RADS 4. Cancer cells were not found in any of 23 lesions defined as PI-RADS 3 (53.5%). Most of the lesions assessed as PI-RADS 3 were located in the transitional zone (n = 19). Only four PI-RADS 3 lesions were found in the peripheral zone. Large lesions or lesions feasible for cognitive TRUS biopsy were not referred for MRI biopsy, which resulted in a higher proportion of lesions assessed as PI-RADS 3. Fourteen lesions suspected of local recurrence were assessed in our study. Cancer was found in approximately 72% of the lesions.

Conclusions: Performing prostate biopsy under the guidance of real-time MRI allows precise collection of material for histological examination (even from a very small lesion). As a result, both primary cancer and local recurrence after previous radiotherapy of prostate cancer can be confirmed.

Abstract

Introduction: The introduction of multiparametric MRI (mpMRI) has been a breakthrough in the diagnosis of noninvasive clinically significant prostate cancer. Currently, MR-guided prostate biopsy (in-bore biopsy) is the only biopsy method that uses real-time MRI in patients with suspected prostate cancer. The aim of the study was a retrospective analysis of the correlation between MRI results and histological findings of prostate samples suspected of malignancy, which were taken during MRI-guided biopsy.

Material and methods: Thirty-nine patients with 57 lesion biopsies were enrolled in the study. Patients were aged 48–84 years (mean age 67.2 ± 9.4 years).

Results: Cancer was histologically confirmed in 24 lesions, including primary cancer in 14 lesions and local recurrence in 10 lesions. Cancer was not detected in the remaining lesions (n = 33). Malignancy was confirmed in 90% of lesions previously reported as PI-RADS 5. Only one Prostate Imaging and Reporting and Data System (PI-RADS 5) lesion was histologically negative (prostatitis). Cancer was detected in 50% of lesions defined as PI-RADS 4. Cancer cells were not found in any of 23 lesions defined as PI-RADS 3 (53.5%). Most of the lesions assessed as PI-RADS 3 were located in the transitional zone (n = 19). Only four PI-RADS 3 lesions were found in the peripheral zone. Large lesions or lesions feasible for cognitive TRUS biopsy were not referred for MRI biopsy, which resulted in a higher proportion of lesions assessed as PI-RADS 3. Fourteen lesions suspected of local recurrence were assessed in our study. Cancer was found in approximately 72% of the lesions.

Conclusions: Performing prostate biopsy under the guidance of real-time MRI allows precise collection of material for histological examination (even from a very small lesion). As a result, both primary cancer and local recurrence after previous radiotherapy of prostate cancer can be confirmed.

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Keywords

prostate; imaging-guided biopsy; core-needle biopsy; multiparametric magnetic resonance imaging; magnetic resonance-guided interventional procedures; biopsy; prostate cancer; prostate neoplasms

About this article
Title

In-bore MR prostate biopsy — initial experience

Journal

Endokrynologia Polska

Issue

Vol 73, No 4 (2022)

Article type

Original paper

Pages

712-724

Published online

2022-07-18

Page views

4469

Article views/downloads

637

DOI

10.5603/EP.a2022.0042

Pubmed

35971938

Bibliographic record

Endokrynol Pol 2022;73(4):712-724.

Keywords

prostate
imaging-guided biopsy
core-needle biopsy
multiparametric magnetic resonance imaging
magnetic resonance-guided interventional procedures
biopsy
prostate cancer
prostate neoplasms

Authors

Justyna Rembak-Szynkiewicz
Piotr Wojcieszek
Anna Hebda
Patrycja Mazgaj
Arkadiusz Badziński
Gabriela Stasik-Pres
Ewa Chmielik
Barbara Bobek-Billewicz

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