Implementation of mpMRI Habitat Risk Scoring System in Prostate Cancer Biopsy Acquisition Improves the Yield of Significant Cancer.

Motivation: The accurate localization and assessment of aggressiveness in patients with prostate cancer is key to appropriate treatment, especially radiation therapy (RT) planning. Goal(s): To evaluate the performance of a Habitat Risk Scoring (HRS) system in MRI/Ultrasound-fused biopsy of prostate cancer at the time of the fiducial marker placement prior to RT. Approach: The yield of significant prostate cancer biopsy findings under HRS guidance was compared with alternative standard techniques. Results: Patients from the Miami BLaStM trial were analyzed with and without HRS guidance. The biopsies obtained through HRS guidance yielded more clinically significant cancer. Impact: The implementation of the Habitat Risk Scoring (HRS) system in transperineal platform for MRI-US biopsies significantly improved the delineation of aggressive cancer. These volumes are integral to the safe delivery of focal escalated radiation doses.