European Journal of Molecular & Clinical Medicine

Abstract

Aim: The comparison of diagnostic accuracy for prostate cancer detection between elastography plus MRI image based TRUS biopsy versus extended core biopsy.
Methods: This Comparative study was carried out in the Department of Radio Diagnosis, RVM Institute of Medical Sciences & Research Centre for the period of 9 months. 50 Patients with age group of 35 to 75 years, with Serum PSA greater than 4.0 ng/dl were included in this study. All patient underwent TRUS biopsy based on the MRI and elastography images, followed by TRUS guided extended core biopsy (13 cores) done by radiologist randomly. The rate of prostate cancer detection was compared between the two types of biopsies. Group A consisted of cores from MRI plus Elastography guided TRUS biopsy and Group B were cores from extended core biopsy.
Results: The mean age of patients was 64.71. The mean serum PSA for patients was 14.70 ng/dl (6.5 to 40.7). 20 cases presented with AUR and patients were catheterized. The mean size of prostate was 51.07 mg (29 to 84 mg). The mean size of prostate and serum PSA of patients with carcinoma prostate were 14.1 mg and 18.4ng/dl respectively. Prostatic carcinoma detection with extended core biopsy was 42% (n=21). The incidence of prostate cancer detection by MRI plus Elastrography guided TRUS is 41 cases (82%). MRI plus Elastrography guided TRUS biopsy method is considered to be statistically significant as the p value is 0.0369 (since p<0.05) as obtained by fishers exact test. In our study majority of the patients had adenomatous hyperplasia (n=30,60%) as the HPE diagnosis, followed by adenocarcinoma (n==20,40%). The sensitivity of mpMRI plus Elastography image based TRUS biopsy method in detecting Prostate cancer was 84.5% and specificity was 82%. The positive predictive value of this method was found to be 80%.
Conclusion: Even while mpMRI and Elastography are each useful alone for detecting prostate cancer, using both diagnostic methods together for TRUS guided enhances the likelihood of cancer diagnosis over extended core biopsy.