Impact of magnetic resonance imaging-guided prostate biopsy in the supine position on the detection of significant prostate cancer in an inhomogeneous patient cohort

Objective: The aim of this study was to determine the tumour detection rate of magnetic resonance-guided biopsy (MRGB) in the supine position for significant prostate cancer in an inhomogeneous patient cohort. Materials and methods: Thirty-two consecutive patients with a total prostate-specific antigen>4 ng/ml and/or a tumour-suspicious palpable lesion upon digital rectal examination and a cancer-suspicious region in multiparametric magnetic resonance imaging (MRI) underwent MRGB in a standard 1.5 T magnet. Diagnostic MRI was performed in 20 patients at the authors' institute and 12 men at another location. Eight patients were investigated at 3 T and 24 at 1.5 T. Twenty men had prior negative biopsies and 12 were biopsy naive. All biopsies were performed in the supine position using a table-mounted device and an 18 G biopsy gun. Results: The overall tumour detection rate was 53% (17/32). Two cores (median; range 1-4) were extracted. Clinically significant cancers were found in 94% (16/17). None of the patients showed any postbiopsy complications. The prostate volumes of patients with cancer were significantly lower (39.3 ml) than those of men without cancer (49.7 ml). No significant differences were found between the numbers of tumour-positive and tumour-negative collected cores. In a median follow-up of 14 months, no cancer was detected in the negative biopsy group. Conclusion: MRGB in the supine position can be a valuable tool to detect significant prostate cancer, even in a patient cohort with different prebiopsy pathways. The biopsy method could be a reasonable alternative to MRGB in the prone position.