FUSION PROSTATE BIOPSY IN PATIENTS WITH PREVIOUS NEGATIVE STANDARD PROSTATE BIOPSY

Introduction. Prostate cancer is one of the common oncological diseases in men. Standard prostate biopsy with subsequent histological verification is now an integral part of the diagnosis of prostate cancer; however, the number of false-negative results and cases of underestimation of the degree of tumor aggressiveness remain excessively high. Advances in multiparametric magnetic resonance imaging have lead to improved detection of prostate tumors.

Objective. Disclosure of the main advantages of prostate biopsy under the magnetic resonance imaging control, consideration of technical aspects of its implementation.

Materials and methods. The fusion of magnetic resonance imaging data with transrectal ultrasound enables the targeted biopsy of suspicious areas. 136 consecutively selected patients were examined, mean age of 62 years, mean prostate volume was 53 cm3, the average prostate-specific antigen 11.3 ng/ml. All the patients underwent at least 1 transrectal prostate biopsy. We assigned patients into 3 groups: group 1 (n=43) underwent repeated standard transrectal biopsy of the prostate; in group 2 (n=39) patients had transperineal biopsy of the prostate; in group 3 there were patients (n=39) in whom a targeted fusion biopsy with magnetic resonance imaging and transrectal ultrasound - navigation has been performed. An average number of biopsy cores in each group was 12, 26.6 and 25.3, respectively.

Results. Prostate cancer was diagnosed in 30.2%, 53.7 % and 56.4 % respectively. Better prostate cancer detectability during fusion biopsy generally occurred due to the localized forms of the disease (93.3 %).

Conclusion. Fusion biopsy using magnetic resonance imaging and transrectal ultrasound and perineal biopsy allows precise determination of prostate cancer pathological stage, Gleason grade of a tumor and its exact localization. Most tumors detectable by saturation perineal biopsy and fusion biopsy using magnetic resonance imaging and transrectal ultrasound were clinically significant, which makes it possible to recommend these methods of biopsy to patients with a high level of suspicion for prostate cancer.

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