Use of TDI during MRI/US fusion-guided biopsy for suspected prostate cancer

Article type: Research Article

Authors: Maxeiner, Andreas^{a; 1} | Fischer, Thomas^{b; 1} | Stephan, Carsten^a | Treskatsch, Selda^b | Baur, Alexander Daniel Jacques^b | Jung, Ernst-Michael^d | Hamm, Bernd^b | Lerchbaumer, Markus Herbert^{b; *}

Affiliations: [a] Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Urology and Berlin Institute for Urologic Research, Berlin, Germany | [b] Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Radiology, Berlin, Germany | [c] Schlosspark-Klinik Charité University Medicine Berlin, Berlin, Germany | [d] Department of Radiology, University Hospital Regensburg, Regensburg, Germany

Correspondence: [*] Corresponding author: Markus H. Lerchbaumer, MD, Department of Radiology, Interdisciplinary Ultrasound Center Charité - Universitätsmedizin Berlin, Campus Charité Mitte, Charitéplatz, 110117 Berlin, Germany. Tel.: +49 0 30 450 657084; Fax: +49 0 30 450 7557901; E-mail: markus.lerchbaumer@charite.de. ORCID: https://orcid.org/0000-0003-1151-9935.

Note: [1] These authors contributed equally to this work.

Abstract: BACKGROUND:Tissue Doppler imaging (TDI) uses the Doppler principle to quantify the movement of biological tissues. OBJECTIVE:To investigate the contribution of TDI parameters derived during magnetic resonance imaging and ultrasound (MRI/US) fusion-guided biopsy for prostate cancer (PCa) discrimination. METHODS:From March 2016 to Dec. 2018, 75 men with suspected PCa prospectively underwent fusion-guided prostate biopsy. TDI overlaid on predefined target lesion were compared to the confirmed contralateral tumor-free area of the prostate gland (using Image J). Diagnostic value of TDI parameters was assessed using histopathology as standard of reference. RESULTS:Thirty-seven patients were diagnosed with PCa (49.3%), among them 27 with clinically significant PCa (Gleason score >  3 + 3 = 6 (ISUP 1). The LES/REF ratio was lower in confirmed PCa patients compared to patients without PCa (0.42, IQR, 0.22–0.59 vs. 0.52, IQR, 0.40–0.72, p = 0.017). TDI parameters allowed differentiation of low-risk from high-to-intermediate-risk PCa (ISUP 2 versus ISUP 3) based on lower pixel counts within the target ROI (1340, IQR 596–2430 vs. 2687, IQR 2453–3216, p = 0.004), lower pixel percentage (16.4 IQR 11.4–29.5 vs. 27.3, IQR 22.1–39.5; p = 0.005), and lower LES/REF ratios (0.29, IQR 0.19–0.51 vs. 0.52, IQR 0.47–0.74, p = 0.001). CONCLUSION:TDI of prostate lesions prelocated by MRI discriminates between cancerous and noncancerous lesions and further seems to enable characterization of PCa aggressiveness. This widely available US technique may improve confidence in target lesion localization for tissue sampling.

Keywords: Tissue doppler imaging, TRUS, transrectal ultrasound, prostate cancer

DOI: 10.3233/CH-201035

Journal: Clinical Hemorheology and Microcirculation, vol. 78, no. 3, pp. 259-269, 2021