Unilateral lesion detected on preoperative multiparametric magnetic resonance imaging and MRI/US fusion-guided prostate biopsy is not an appropriate indication for focal therapy in prostate cancer

Urol Oncol. 2021 Oct;39(10):730.e17-730.e22. doi: 10.1016/j.urolonc.2021.04.021. Epub 2021 Jun 24.

Abstract

Purpose: This study aimed to investigate if preoperative assessments of multiparametric magnetic resonance imaging (mpMRI) and Magnetic resonance imaging /ultrasound (MRI/US) fusion-guided prostate biopsy could be used to guide focal therapy for prostate cancer.

Materials and methods: A total of 101 prostate cancer patients undergoing radical prostatectomy were included. Preoperative findings included mpMRI and MRI/US fusion-guided prostate biopsy, while postoperative whole mount pathology was based on surgical specimen.

Results: Of the 101 patients preoperatively diagnosed with a unilateral tumor, postoperative whole mount pathology showed 73.27% were bilateral tumors, and 71.62% of bilateral lesions were clinically significant. Comparison between preoperative and postoperative findings, the correct rate of preoperative mpMRI on the lesion side (left or right) was only 20.79%. As for the Gleason score, the correct rate of preoperative MRI/US fusion-guided prostate pathology was 67.33%. Judging from postoperative whole mount pathology, 47.52% of patients had a unilateral clinically significant tumor, which is an indication for focal therapy.

Conclusion: Preoperative examinations of mpMRI and MRI/US fusion-guided prostate biopsy cannot be used to guide focal therapy for prostate cancer.

Keywords: Focal therapy; Imaging guided biopsy; Magnetic resonance imaging /ultrasound (MRI/US) fusion-targeted biopsy; prostate cancer.

MeSH terms

  • Aged
  • Humans
  • Image-Guided Biopsy / methods*
  • Male
  • Multiparametric Magnetic Resonance Imaging / methods*
  • Preoperative Period
  • Prostate / pathology*
  • Prostatic Neoplasms / diagnostic imaging*
  • Prostatic Neoplasms / surgery*
  • Retrospective Studies