MRI/ultrasound fusion biopsy accurately detects PCa in men with intermediate PSA

Fusion biopsy with magnetic resonance imaging and ultrasonography (MRI/US) is an efficient method of detecting clinically significant prostate cancer (csPCa) in biopsy-naïve men with prostate specific antigen (PSA) levels 4–10 ng/mL, a new study has found.

However, when PSA is <4 or ≥10 ng/mL, standard transrectal ultrasound (TRUS) may be a more efficient option, further emphasizing the importance of using a combination of detection approaches.

Researchers conducted a propensity-matched retrospective review of 390 men who underwent either standard TRUS (n=195) or MRI/US fusion biopsy (n=195). Analysis was stratified according to PSA: <4, 4–10, and >10 ng/mL.

In both the unmatched (39.8 percent vs 37.2 percent; p=0.502) and matched (43.0 percent vs 38.9 percent; p=0.163), the detection rate of csPCa was statistically comparable between MRI/US fusion and standard TRUS, respectively.

However, in men with PSA levels 4–10 ng/mL, fusion biopsy showed significant superiority to standard TRUS, yielding corresponding detection rates of 35.0 percent and 26.6 percent (p=0.033). No such effect was reported in the subgroups of men with PSA <4 ng/mL (12.0 percent vs 16.0 percent; p=0.342) and >10 ng/mL (78.0 percent vs 80.0 percent; p=0.596).

Multivariate analysis further confirmed that MRI/US fusion biopsy was associated with csPCa in men with PSA 4–10 ng/mL (odds ratio, 2.46, 95 percent confidence interval, 1.31–4.60; p=0.005).