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. 2018 Sep;7(Suppl 4):S392-S396.
doi: 10.21037/tau.2018.03.15.

Detection of extraprostatic disease and seminal vesicle invasion in patients undergoing magnetic resonance imaging-targeted prostate biopsies

Erin M Baumgartner  1 , Kristin K Porter  2 , Jeffrey W Nix  3 , Soroush Rais-Bahrami  2   3 , Jennifer B Gordetsky  1   2
Affiliations

Detection of extraprostatic disease and seminal vesicle invasion in patients undergoing magnetic resonance imaging-targeted prostate biopsies

Erin M Baumgartner et al. Transl Androl Urol. 2018 Sep.

Abstract

Background: Finding incidental extraprostatic extension (EPE) or seminal vesicle invasion (SVI) by prostate cancer (PCa) is rare on standard prostate biopsy. We evaluated the clinical-pathologic features associated with EPE and SVI on multiparametric magnetic resonance imaging (MRI)/ultrasound (US) fusion-guided targeted biopsy (TB).

Methods: A retrospective review was performed from 2014-2017, selecting patients who had undergone TB. Clinical, pathologic, and radiologic features were evaluated.

Results: Five out of 333 (1.5%) patients who had PCa detected on TB had EPE and/or SVI. The average age and prostate-specific antigen (PSA) was 71 years and 17 ng/mL, respectively. The average number of cores taken on TB was 4.2. Two patients had a prior negative SB and two patients had a prior positive SB, one of which underwent radiation therapy. All patients had a PIRADSv2 suspicion score of 4 or 5. Four out of five (80%) patients underwent both SB and concurrent TB, of which 3/4 (75%) had EPE identified only on TB. One out of four (25%) patients also had both EPE and SVI, identified only on TB. One patient underwent only TB for MRI suspicion of SVI, which was pathologically confirmed on TB. On TB, one patient had Grade Group 3, two patients had Grade Group 4, and two patients had Grade Group 5 PCa. Perineural invasion (PNI) was present in 4/5 (80%) patients on TB.

Conclusions: Based on our small series, we hypothesize that MRI/US fusion TB outperforms SB in the identification of EPE and SVI. However, given the small sample size and the overall rarity of these pathologic findings on prostate biopsy, further validation is needed.

Keywords: Prostate cancer (PCa); cancer grading; cancer staging; multiparametric magnetic resonance imaging (MRI).

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Conflict of interest statement

Conflicts of Interest: JW Nix and S Rais-Bahrami serve as consultants for Philips/InVivo Corp.

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References

    1. Fleshner K, Assel M, Benfante N, et al. Clinical Findings and Treatment Outcomes in Patients with Extraprostatic Extension Identified on Prostate Biopsy. J Urol 2016;196:703-8. 10.1016/j.juro.2016.03.152 - DOI - PMC - PubMed
    1. Siddiqui MM, Rais-Bahrami S, Turkbey B, et al. Comparison of MR/ultrasound fusion-guided biopsy with ultrasound-guided biopsy for the diagnosis of prostate cancer. JAMA 2015;313:390-7. 10.1001/jama.2014.17942 - DOI - PMC - PubMed
    1. Puech P, Rouvière O, Renard-Penna R, et al. Prostate cancer diagnosis: multiparametric MR-targeted biopsy with cognitive and transrectal US-MR fusion guidance versus systematic biopsy--prospective multicenter study. Radiology 2013;268:461-9. 10.1148/radiol.13121501 - DOI - PubMed
    1. Borkowetz A, Platzek I, Toma M, et al. Comparison of systematic transrectal biopsy to transperineal magnetic resonance imaging/ultrasound-fusion biopsy for the diagnosis of prostate cancer. BJU Int 2015;116:873-9. 10.1111/bju.13023 - DOI - PubMed
    1. Gordetsky JB, Thomas JV, Nix JW, et al. Higher Prostate Cancer Grade Groups Are Detected in Patients Undergoing Multiparametric MRI-targeted Biopsy Compared With Standard Biopsy. Am J Surg Pathol 2017;41:101-5. 10.1097/PAS.0000000000000723 - DOI - PubMed