MRI fusion biopsy vs transrectal ultrasound guided biopsy – A literature review

Introduction: Current diagnosis of prostate cancer is based on transrectal ultrasound guided random biopsies. These procedures alongside with the discovery of PSA lead to a tremendous improvement of prostate cancer diagnosis rate in the last decades. Random ultrasound guided biopsy has its minuses and several attempts were made to improve the detection rate of the disease. MRI-US fusion targeted biopsies is one of them. Aim: This paper is a literature review of several important European studies and tries to draw a conclusion for the usefulness of MRI-US image fusion prostate biopsy in improving prostate cancer detection Material and methods: We have analyzed 5 papers published since 2013 which compare random ultrasound biopsies with MRI-US fusion. The analyzed parameters were clinical significant cancer detected as described by the study and any cancer detected Results: All 5 papers show superiority in cancer detection rates for both clinically significant and any cancer. Conclusions: MRI-US is a useful tool for improving detection rate of clinically significant prostate cancer. INTRODUCTION in general Prostate cancer is a serious public health matter, being the first cancer in men in terms of incidence and the second cause of cancer death in the U.S. in the Cancer, following year cardiovascular diseases as the leading cause of mortality. Prostate cancer, in particular is becoming more and more important due population aging. [1] is taught to surpass While throughout the history prostate cancer was poorly understood, with few cases recorded due to the low life expectancy, during the XXth century groundbreaking understanding, diagnosing and treating the disease. discoveries were made in Early diagnosis methods included open transperineal biopsies, blind transperineal needle biopsy and finger guided transrectal biopsy. First attempts to use transrectal ultrasound for prostate imaging were made by Takahasi and Ouchi in 1963 but they in 1968 obtained poor performed first clinical useful TRUS. In 1989 Hodge and al. started the modern era of standard sextant [2]. Watanabe images 1 Carol Davila Central University Emergency Military Hospital, Bucharest 2 Saarbrucken, Germania 3 Carol Davila University of Medicine and Pharmacy, Bucharest 5