Reproducibility of Multiparametric Magnetic Resonance Imaging and Fusion Guided Prostate Biopsy: Multi-Institutional External Validation by a Propensity Score Matched Cohort

Ardeshir R. Rastinehad, Steven F. Abboud, Arvin K. George, Thomas P. Frye, Richard Ho, Raju Chelluri, Michele Fascelli, Joanna Shih, Robert Villani, Eran Ben-Levi, Oksana Yaskiv, Baris Turkbey, Peter L. Choyke, Maria J. Merino, Bradford J. Wood, Peter A. Pinto

Research output: Contribution to journalArticlepeer-review

19 Scopus citations

Abstract

Purpose As the adoption of magnetic resonance imaging/ultrasound fusion guided biopsy expands, the reproducibility of outcomes at expert centers becomes essential. We sought to validate the comprehensive NCI (National Cancer Institute) experience with multiparametric magnetic resonance imaging and fusion guided biopsy in an external, independent, matched cohort of patients. Materials and Methods We compared 620 patients enrolled in a prospective trial comparing systematic biopsy to fusion guided biopsy at NCI to 310 who underwent a similar procedure at Long Island Jewish Medical Center. The propensity score, defined as the probability of being treated outside NCI, was calculated using the estimated logistic regression model. Patients from the hospital were matched 1:1 for age, prostate specific antigen, magnetic resonance imaging suspicion score and prior negative biopsies. Clinically significant disease was defined as Gleason 3 + 4 or greater. Results Before matching we found differences between the cohorts in age, magnetic resonance imaging suspicion score (each p <0.001), the number of patients with prior negative biopsies (p = 0.01), and the overall cancer detection rate and the cancer detection rate by fusion guided biopsy (each p <0.001). No difference was found in the rates of upgrading by fusion guided biopsy (p = 0.28) or upgrading to clinically significant disease (p = 0.95). A statistically significant difference remained in the overall cancer detection rate and the rate by fusion guided biopsy after matching. On subgroup analysis we found a difference in the overall cancer detection rate and the rate by fusion guided biopsy (p <0.001 and 0.003) in patients with prior negative systematic biopsy but no difference in the 2 rates (p = 0.39 and 0.51, respectively) in biopsy naïve patients. Conclusions Improved detection of clinically significant cancer by magnetic resonance imaging and fusion guided biopsy is reproducible by an experienced multidisciplinary team consisting of dedicated radiologists and urologists.

Original languageEnglish
Pages (from-to)1737-1743
Number of pages7
JournalJournal of Urology
Volume195
Issue number6
DOIs
StatePublished - 1 Jun 2016

Keywords

  • adenocarcinoma
  • biopsy
  • magnetic resonance imaging
  • prostate
  • ultrasound, high-intensity focused, transrectal

Fingerprint

Dive into the research topics of 'Reproducibility of Multiparametric Magnetic Resonance Imaging and Fusion Guided Prostate Biopsy: Multi-Institutional External Validation by a Propensity Score Matched Cohort'. Together they form a unique fingerprint.

Cite this