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Prostate cancer detection rate of MRI/TRUS fusion vs. TRUS systematic biopsy. Impact of MRI setting and indications on biopsy outcome

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PROSTATE CANCER DETECTION RATE OF MRI/TRUS FUSION VS. TRUS SYSTEMATIC BIOPSY. IMPACT OF MRI SETTING AND INDICATIONS ON BIOPSY OUTCOME.

Luigi Cormio1 , Oscar Selvaggio1, Giovanni Silecchia1, Francesco Troiano1, Giuseppe Di Fino1,  Vito Mancini1, Francesca Sanguedolce3, Paola Milillo2, Luca Macarini2, Giuseppe Carrieri1
1 Dep of Urology, University Of Foggia, Foggia (Italy); 2 Dep of Radiology, University Of Foggia, Foggia (Italy); 3 Dep of Pathological Anatomy , University Of Foggia, Foggia (Italy); 

AIM: we evaluated our initial experience with mpMRI/TRUS fusion guided PBx and potential differences between the urologist-driven in-house and the non urologist-driven non in-house mpMRI setting.

MATERIAL & METHODS: we compared the first 64 patients having undergone mpMRI/TRUS fusion guided PBx (Group A) with a matched population of patients having undergone standard TRUS-guided PBx (Group B) in the same period.

RESULTS: the overall cancer detection rate (CDR) was 21.8% in Group A and 29.7% in Group B. In patients with clinical and MRI indication for PBX the CDR raised to 32.5%, whereas in those with only MRI indication for PBx, the CDR was 4.2%. the CDR for PIRADS 4 and 5 lesions was higher for the in-house vs. the non in-house setting  (45.4 vs. 36.4% and 50 vs. 0%).

CONCLUSIONS: mpMRI/TRUS fusion guided PBx did not provide better results than TRUS guided systematic PBx. Urologists have to face the problem of patients referred for PBx on the basis of mpMRI only, a setting whereby our CDR proved to be less than 5%.

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