Urologic Survey (Urooncology)

Re: Transurethral Resection of the Prostate Biopsy of Suspected Anterior Prostate Cancers Identified by Multiparametric Magnetic Resonance Imaging: A Pilot Study of a Novel Technique


  • Özgür Yaycioglu

J Urol Surg 2016;3(2):55-55


miss or undersample anterior prostate cancers (APCs). Multiparametric magnetic resonance imaging (mpMRI) plays an increasing role in the diagnosis of prostate cancer. In this study, the authors report a novel technique of cognitively directed transurethral resection of the prostate (TURP) to biopsy APCs identified by mpMRI and evaluate the feasibility of this approach among participants with prior negative TRUS-guided biopsies. Participants aged 50-75 years were offered inclusion if they had an elevated prostate-specific antigen level, a lesion suspicious for APC on mpMRI, and at least 1 prior negative TRUS-guided prostate biopsy with a minimum of 10 cores. Exclusion criteria included previous pathologically confirmed prostate cancer, nonanterior prostate lesions, multiple lesions on mpMRI, prostate lesions having benign appearance on mpMRI, and prostate lesions abutting the external urethral sphincter. The TURP biopsy procedure was cognitively directed on the basis of the suspected APC location in 3 dimensions, which had been previously noted from the mpMRI images and the anticipated APC location was resected. A total of 16 consecutive participants were enrolled. Thirteen (81.3%) participants had clinically significant APC detected by TURP biopsy. Seven participants (43.8%) underwent radical prostatectomy that confirmed clinically significant disease in all 7 participants. This study shows that among patients with anterior prostate lesions on mpMRI and prior negative TRUS-guided biopsy, TURP biopsy detects some clinically significant cancers and comparative trials on the concept are needed.