2 research outputs found
The addition of a sagittal image fusion improves the prostate cancer detection in a sensor-based MRI /ultrasound fusion guided targeted biopsy
Background To explore the diagnostic benefit of an additional image fusion of
the sagittal plane in addition to the standard axial image fusion, using a
sensor-based MRI/US fusion platform. Methods During July 2013 and September
2015, 251 patients with at least one suspicious lesion on mpMRI (rated by PI-
RADS) were included into the analysis. All patients underwent MRI/US targeted
biopsy (TB) in combination with a 10 core systematic prostate biopsy (SB). All
biopsies were performed on a sensor-based fusion system. Group A included 162
men who received TB by an axial MRI/US image fusion. Group B comprised 89 men
in whom the TB was performed with an additional sagittal image fusion. Results
The median age in group A was 67 years (IQR 61–72) and in group B 68 years
(IQR 60–71). The median PSA level in group A was 8.10 ng/ml (IQR 6.05–14) and
in group B 8.59 ng/ml (IQR 5.65–12.32). In group A the proportion of patients
with a suspicious digital rectal examination (DRE) (14 vs. 29%, p = 0.007) and
the proportion of primary biopsies (33 vs 46%, p = 0.046) were significantly
lower. The rate of PI-RADS 3 lesions were overrepresented in group A compared
to group B (19 vs. 9%; p = 0.044). Classified according to PI-RADS 3, 4 and 5,
the detection rates of TB were 42, 48, 75% in group A and 25, 74, 90% in group
B. The rate of PCa with a Gleason score ≥7 missed by TB was 33% (18 cases) in
group A and 9% (5 cases) in group B; p-value 0.072. An explorative
multivariate binary logistic regression analysis revealed that PI-RADS, a
suspicious DRE and performing an additional sagittal image fusion were
significant predictors for PCa detection in TB. 9 PCa were only detected by TB
with sagittal fusion (sTB) and sTB identified 10 additional clinically
significant PCa (Gleason ≥7). Conclusion Performing an additional sagittal
image fusion besides the standard axial fusion appears to improve the accuracy
of the sensor-based MRI/US fusion platform