Reconciling Discordance Between Prostate Biopsy Histology and Magnetic Resonance Imaging Suspicion - Implementation of a Quality Improvement Protocol of Imaging Re-review and Reverse-fusion Target Analysis.

Journal Article

There is uncertainty with how to proceed when targeted prostate biopsy of suspicious multiparametric magnetic resonance imaging (mpMRI) lesions return without clinically significant prostate cancer (csPCa). While possible, there are error sources that could contribute to such discordance including the mpMRI read, mpMRI-ultrasound fusion, biopsy technique, and histologic classification. Consequences are potentially significant; mistakenly missing csPCa can lead to delays in curative treatment. Conversely, in cases of incorrect mpMRI interpretation, the patient may be subjected to unnecessary workup/burden. At our institution, we implemented a quality improvement (QI) initiative triggered after a discordant case occurs. This multidisciplinary review process incorporates mpMRI re-review and assessment of accurate lesion-sampling, termed "reverse-fusion." Herein, we describe the protocol, present sample cases, and discuss clinical implications.

Full Text

Duke Authors

Cited Authors

  • Kotamarti, S; Gupta, RT; Wang, B; Séguier, D; Michael, Z; Zhang, D; Abern, MR; Huang, J; Polascik, TJ

Published Date

  • October 2022

Published In

Volume / Issue

  • 5 / 5

Start / End Page

  • 483 - 493

PubMed ID

  • 35879190

Electronic International Standard Serial Number (EISSN)

  • 2588-9311

Digital Object Identifier (DOI)

  • 10.1016/j.euo.2022.06.007


  • eng

Conference Location

  • Netherlands