caa a22 4500 605493499 CHVBK 20210128100521.0 cr unu---uuuuu 210128e20151001xx s 000 0 eng 10.1007/s00261-015-0426-8 doi (NATIONALLICENCE)springer-10.1007/s00261-015-0426-8 Posterior subcapsular prostate cancer: identification with mpMRI and MRI/TRUS fusion-guided biopsy [Elektronische Daten] [Sandeep Sankineni, Arvin George, Anna Brown, Soroush Rais-Bahrami, Bradford Wood, Maria Merino, Peter Pinto, Peter Choyke, Baris Turkbey] Purpose: The posterior subcapsular region of the prostate is often undersampled by transrectal ultrasound (TRUS)-guided biopsy. The close proximity of these lesions to the posterior capsular wall of the prostate makes them difficult to localize while increasing the need for early detection because of their increased risk for extracapsular extension. We retrospectively evaluated the multiparametric MRI (mpMRI) features of subcapsular prostate cancers to make radiologists more aware of this condition. Materials and Methods: Between January 2010 and July 2014, all patients referred for 3T mpMRI and subsequent MR-US Fusion-guided biopsy (FgBx) and systematic 12-core sextant biopsy (SBx) under an IRB approved protocol, were reviewed, and imaging confirmed subcapsular prostate cancers were identified. Subcapsular lesions were defined as thin lesions that were just inside the prostate capsule. Matching patient demographics and clinical findings including age, PSA, PSA density, whole prostate volume, history of prostate cancer, Gleason score, and clinical management were tabulated. Results: Of 992 eligible patients, 33 patients had subcapsular lesions in the prostate detected by mpMRI. Mean age, PSA, and prostate volume in this group were 63years (range: 52-76years), 8.4ng/mL (range: 1.22-65.20), and 53mL (range: 12-125mL), respectively. The combination biopsy (SBx+FgBx) confirmed prostate cancer in 24 of 33 patients (72.7%) and in 9 patients the biopsy was negative. Of the 24 cancers, 19 were confirmed on both FgBx and conventional biopsy; however, 5 cancers were only detected on FgBx. In 4 of the 19 patients in which both biopsy methods were positive, the FgBx yielded a higher Gleason score. Conclusion: Subcapsular lesions on mpMRI are relatively infrequent but are usually malignant. Although the majority are confirmed on conventional 12-core biopsies, about 20% of these lesions require FgBx for diagnosis, and FgBx more accurately grades the lesions in another 20%. Thus, FgBx is of considerable benefit in confirming the diagnosis of subcapsular prostate cancer despite their proximity to the prostatic capsule. Springer Science+Business Media New York (outside the USA), 2015 Prostate cancer nationallicence Subcapsular nationallicence MRI nationallicence Fusion guided biopsy nationallicence Sankineni Sandeep Molecular Imaging Program, NCI, NIH, Bethesda, MD, USA aut George Arvin Urologic Oncology Branch, NCI, NIH, Bethesda, MD, USA aut Brown Anna Molecular Imaging Program, NCI, NIH, Bethesda, MD, USA aut Rais-Bahrami Soroush Urologic Oncology Branch, NCI, NIH, Bethesda, MD, USA aut Wood Bradford Center for Interventional Oncology, NCI and Radiology and Imaging Sciences, Clinical Center, NIH, Bethesda, MD, USA aut Merino Maria Laboratory of Pathology, NCI, NIH, Bethesda, MD, USA aut Pinto Peter Urologic Oncology Branch, NCI, NIH, Bethesda, MD, USA aut Choyke Peter Molecular Imaging Program, NCI, NIH, Bethesda, MD, USA aut Turkbey Baris Molecular Imaging Program, NCI, NIH, Bethesda, MD, USA aut Abdominal Imaging Springer US; http://www.springer-ny.com 40/7(2015-10-01), 2557-2565 0942-8925 40:7<2557 2015 40 261 https://doi.org/10.1007/s00261-015-0426-8 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00261-015-0426-8 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Sankineni Sandeep Molecular Imaging Program, NCI, NIH, Bethesda, MD, USA aut NATIONALLICENCE 700 1- George Arvin Urologic Oncology Branch, NCI, NIH, Bethesda, MD, USA aut NATIONALLICENCE 700 1- Brown Anna Molecular Imaging Program, NCI, NIH, Bethesda, MD, USA aut NATIONALLICENCE 700 1- Rais-Bahrami Soroush Urologic Oncology Branch, NCI, NIH, Bethesda, MD, USA aut NATIONALLICENCE 700 1- Wood Bradford Center for Interventional Oncology, NCI and Radiology and Imaging Sciences, Clinical Center, NIH, Bethesda, MD, USA aut NATIONALLICENCE 700 1- Merino Maria Laboratory of Pathology, NCI, NIH, Bethesda, MD, USA aut NATIONALLICENCE 700 1- Pinto Peter Urologic Oncology Branch, NCI, NIH, Bethesda, MD, USA aut NATIONALLICENCE 700 1- Choyke Peter Molecular Imaging Program, NCI, NIH, Bethesda, MD, USA aut NATIONALLICENCE 700 1- Turkbey Baris Molecular Imaging Program, NCI, NIH, Bethesda, MD, USA aut NATIONALLICENCE 773 0- Abdominal Imaging Springer US; http://www.springer-ny.com 40/7(2015-10-01), 2557-2565 0942-8925 40:7<2557 2015 40 261