De toegevoegde waarde van magnetic resonance imaging in detectie van prostaatkanker.

Objective:
To determine detection rates of MRGB comparing to TRUSGB and MRUSFGB within patients who are at risk for prostate cancer but have no histological prove of prostate cancer, and who underwent at least one negative TRUSGB.


Secondary Objectives:
To determine the percentage of patients upgraded for MRGB compared to TRUSGB.
To determine detection rates of MRUSFGB.


Study design: A prospective cohort study.


Study population:
Patients who underwent at least one negative TRUSGB with a PSA¡Ý4 and who are suspected of having prostate cancer without having histological proof of prostate cancer.


Intervention:
Patients will undergo a multimodality MRI consisting of anatomic T2 weighted MRI (T2W), Dynamic Contrast enhanced MRI (DCE) and Diffusion weighted (DWI) MRI. During a second visit a 10 core standard TRUSGB will be taken. Ultrasound images will be fused with processed MR images. After TRUSGB, the examiner will switch to the Fusion mode within the same examination and 2 cores at MRUSFGB of each tumor suspected region (TSR) will be taken up to a maximum of 4 cores ( maximum of 2 TSR¡¯s). Deze eerste sessie is dus puur wetenschap, c.q. voor de patienten die specifiek voor MRI biopten komen ¡°voor niets¡±After 4 weeks the patient will undergo MRGB (maximum of 2 cores of each TSR up to a maximum of 4 cores). All specimens will be examined by one specialised pathologist. In each patient one TRUSGB, one MRUSFGB and one MRGB procedure will be performed.

MRI leads to higher prostate cancer detection: MR guided prostate biopsy and MR-ULtrasound Fusion Guided prostate biopsy will yield higher detection rates in comparison to Transrectal Ultrasound guided prostate biopsy.

8 weeks after inclusion. After inclusion of all patients necessary.

1. MRI examination of the prostate;

2. MR guided prostate biopsy;

3. MR ultrasound Fusion guided prostate biopsy;

4. Transrectal Ultrasound guided prostate biopsy.