This paired cohort blinded trial aims to assess the detection rate of clinically significant cancer of MRI-targeted biopsy compared to standard 12-core TRUS biopsy in men referred with clinical suspicion of prostate cancer who have had no prior prostate biopsy. The investigators hypothesize that additional MRI-targeted biopsy will detect more clinically significant cancers than standard TRUS biopsy. Main objective: To compare MR-target vs. standard 12-cores TRUS-biopsy for the diagnosis of clinically significant prostate cancer.
Before prostate biopsy, all patients be preceded by mpMRI. The mpMRI is read by an experienced radiologist according to the PI-RADS version 2 scoring system. PI-RADS scoring system is used to assign a degree of doubt prostate cancer. Depending on the PI-RADS score, MR targeted biopsy is determined. 1. MR-targeted biopsy using Artemis device fusion of MRI and ultrasound images would be performed. MR targeted biopsy would be performed by radiologist. 2. Next conventional ultrasound-guided 12-core systematic biopsy would be performed by urologist. This portion will be performed without information of the MRI report.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
DIAGNOSTIC
Masking
NONE
Enrollment
300
Before prostate biopsy, all patients be preceded by mpMRI.MR-targeted biopsy using Artemis device fusion of MRI and ultrasound images would be performed. MR targeted biopsy would be performed by radiologist.
Asan Medical Center
Seoul, South Korea
RECRUITINGProportion of clinically significant prostate cancer (≥Gleason score 3+4)
Time frame: 2 week after the procedure
Proportion of clinically insignificant prostate cancer (Gleason score 6)
Time frame: 2 week after the procedure
Proportion of men in whom mpMRI score (PI-RADS) for suspicion of clinically significant cancer was 3, 4 or 5
Time frame: 2 week after the procedure
Correlation of prostate health index (Phi), phi density and MRI fusion Bx in predicting clinically significant prostate cancer
Time frame: 2 week after the procedure
Cancer core length of the most involved biopsy core (maximum cancer core length, mm)
Time frame: 2 week after the procedure
Proportion of men who go on to definitive local treatment or systemic treatment
Time frame: 2 week after the procedure
Proportion of Gleason grade upgrading in men undergoing radical prostatectomy
Time frame: 2 week after the surgery
Adverse events of post-biopsy (pain, infection, bleeding etc.)
Time frame: 2 week after the procedure
Inter-observer variability among radiologists
Time frame: 2 week after the procedure
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