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Cancer Imaging

Open Access

Multiparametric magnetic resonance tomography and MRI/TRUS-fusion-biopsy for index lesion detection: correlation with radical prostatectomy specimen

  • JP Radtke1Email author,
  • C Schwab1,
  • MB Wolf2,
  • MT Freitag2,
  • C Alt3,
  • C Kesch1,
  • IV Popeneciu1,
  • C Huettenbrink1,
  • C Bergstraesser-Gasch1,
  • T Klein1,
  • S Duensing1,
  • S Roth4,
  • HP Schlemmer2,
  • M Roethke2,
  • M Hohenfellner1 and
  • B Hadaschik1
Cancer Imaging201515(Suppl 1):S1

Published: 2 October 2015


Prostate CancerTumour VolumeRadical ProstatectomyGleason ScoreSpearmans Correlation Analysis


Multiparametric MRI (mpMRI) and MRI-targeted fusion-biopsy (TB) detect significant prostate cancer (PC) more accurately than conventional biopsies alone. The aim of this study was to evaluate the detection accuracy by mpMRI and TB on radical prostatectomy (RP) specimen.


We selected 120 consecutive patients who underwent transperineal fusion-biopsy before RP. All men received a saturation biopsy (SB) in addition to targeted biopsies of lesions with PIRADS≥2. On RP specimen, the index lesion was defined as highest Gleason score (GS) or highest tumour volume (TV). GS=3+3 and TV≥1.2ml or GS=3+4 and TV≥0.7ml or GS>3+4 were considered significant PC. We performed Spearmans correlation analysis between mpMRI and RP and Fisher`s test between mpMRI, TB and SB.


Overall, 120 index lesions and 71 non-index lesions were detected. 107 index and 51 non-index lesions harbored significant PC. MpMRI detected 110/120(91.7%) index lesions, while TB alone diagnosed only 96/120(80.0%) and SB alone 110/120(91.7%). The combination of SB and TB detected 115/120(95.8%) index foci. The combination of TB and SB outperformed TB alone (p=0.017) for detection of all significant PC. Additionally, TB performed significantly worse compared to SB alone for all significant tumour detection (p=0.034). Spearmans correlation coefficient for index lesion concordance between mpMRI and RP was 0.865(p<0.001). TB provided greatest benefit in men undergoing repeat biopsy.


MpMRI detected 91.7% index lesions compared to RP. However, TB alone missed 21.5% of all significant foci. Thus, the combination of both biopsy approaches should be incorporated in the biopsy workflow to predict PC most accurately.

Authors’ Affiliations

Department of Urology University Hospital Heidelberg, Heidelberg, Germany
Department of Radiology German Cancer Research Center Heidelberg, Heidelberg, Germany
Department of Diagnostic and Interventional Radiology University, Hospital Dusseldorf, Dusseldorf, Germany
Institute of Pathology University Hospital, Heidelberg, Germany


© Radtke et al. 2015

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.