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Introduction: It is unclear whether MRI-Fusion prostate biopsy (TBx) will be useful in general clinical practice due to radiologic/cost constraints. We sought to evaluate a large community group 1-year use of MRI-targeted fusion prostate biopsy (TBx).
Materials & Methods: We prospectively identified men with clinical parameters who met criteria for prostate mpMRI with IRB approval. Over a 12-month period, 520 mpMRI’s were done, and 100 fusion-guided biopsies were performed using the Uronav platform. Radiographic confirmation and location of the MRI targets were centrally reviewed. Biopsies were done in ASC setting using a clinical pathway. Data was accrued, including patient age, PSA, PSAD, prostate size, MRI lesion size and location.
Results: Mean age/PSA/PSAD/prostate volume were 64 years/ 8.7ng/ml /0.25 /42cc. A third of patients had 2 or more prior Bx, 30% had prior cancer diagnosis, and 76% had concurrent standard Bx for review. Primary targets were noted anterior or TZ in 42% of cases. Median MRI lesion size was 9mm (3-36 mm). TBx was successful in identifying cancer in 67% of patients (LG-21/IG-27/HG-19) . Standard Bx found cancer in 14/33 of men with negative TBX (5/14 Gleason 7+). Of 40 patients with concurrent TBX+ & prostatectomy, 30/40 had Gleason 7 cancer or higher.
Conclusions: Our community based practice has been successful in integrating MRI-Fusion prostate biopsy into daily clinical practice, and our results support its use as relevant prostate cancer was found in a majority of patients. We will continue to recommend concurrent standard biopsy for all patients at this time.