The transrectal ultrasound/MRI fusion biopsy for prostate cancer diagnosis after previous negative biopsy: a case report

Abstract

Introduction: The adoption of multiparametric MRI (mpMRI) guided fusion biopsy is becoming an important tool to improve the diagnostic yield in those suspected of having prostate cancer, especially for patients with suspicious lesion located at the anterior region that is uncommonly sampled at randomized biopsy. Methods: Herein we report a case of a man with persistent elevated PSA and a previous negative randomized prostate biopsy. His PSA was 8.1 ng/dL and a multiparametric MRI showed a 2cm suspicious PIRADS-4 lesion located at the anterior region of the right transition zone at base and mid gland. A transrectal ultrasound/MRI (TRUS/mpMRI) fusion biopsy was performed and its pathologic report showed a Gleason 3+4 (ISUP II) that was present only in the fragments that sampled the suspected area at MRI. We review the role of mpMRI in the diagnosis of prostate cancer at rebiopsy.