Open Access

ARTICLE

Impact of post prostate biopsy hemorrhage on multiparametric magnetic resonance imaging

Ali-Reza Sharif-Afshar¹, Tom Feng¹, Steven Koopman¹, Christopher Nguyen², Quanlin Li³, Eugene Shkolyar¹, Rola Saouaf², Hyung L. Kim¹

1 Division of Urology, Cedars-Sinai Medical Center, Los Angeles, California, USA
2 Department of Radiology, Cedars-Sinai Medical Center, Los Angeles, California, USA
3 Biostatistical Core, Cedars-Sinai Medical Center, Los Angeles, California, USA
Address correspondence to Dr. Hyung L. Kim, Department of Urology, Cedars Sinai Medical Center, 8635 West Third Street, Suite 1070 West, Los Angeles, CA90048 USA

Canadian Journal of Urology 2015, 22(2), 7698-7702.

Abstract

Introduction: Hemorrhage induced by prostate biopsy can interfere with the interpretation of prostate magnetic resonance imaging (MRI).
Materials and methods: We reviewed 101 patients who had prostate multiparametric MRI (MP-MRI) and radical prostatectomy.
Results: On MRI obtained within 4 weeks following the biopsy, hemorrhage was seen in 26/36 (72.2%) patients. Patients having a MRI between 4-6 weeks of the biopsy had hemorrhage in 8/14 (57.1%) cases. After 6 weeks, hemorrhage was less common but still present in 24/46 (52%) patients. There were five patients who had prostate MRI prior to biopsy and served as a control group. There was no significant correlation between the length of time beyond 6 weeks and the likelihood of having prostate hemorrhage on MRI.
The overall sensitivity and specificity of MRI for predicting extracapsular extension (ECE) were 78.6% and 89%, respectively. However, if the analysis was limited to patients with MRI within 6 weeks from the time of biopsy, the sensitivity and specificity were similar: 80% and 90%, respectively. For patients with MRI obtained after 6 weeks, the sensitivity and specificity were 76.9% and 87.9%.
Conclusions: Prostate hemorrhage is seen in the majority of cases within 6 weeks of biopsy and can be seen in nearly half the patients even beyond 6 weeks. However, hemorrhage within 6 weeks of a biopsy does not interfere with assessment for ECE.

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