Chen Valerie H, Mouraviev Vladimir, Mayes Janice M, Sun Leon, Madden John F, Moul Judd W, Polascik Thomas J
Duke Prostate Center and Division of Urologic Surgery, Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA.
Technol Cancer Res Treat. 2009 Apr;8(2):99-104. doi: 10.1177/153303460900800202.
The 3-D transrectal ultrasound (TRUS)-guided prostate biopsy system is a novel device that allows precise needle placement in a template fashion. We evaluate its utility for prostate cancer (PCa) detection. A retrospective analysis was performed evaluating 68 prospective patients at the Duke Prostate Center who underwent a prostate biopsy using a 3-D TRUS-guided system. After creation of a three-dimensional map of the prostate, a computer algorithm identified an ideal biopsy scheme based on the measured dimensions of the prostate. The system then used a fixed template that allowed prostate biopsy at specific locations with the ability to target the same region of the prostate in the future if needed. For all patients, a 12-core biopsy pattern was used to cover medial and lateral areas of the base, mid-gland, and apex. In total, 68 patients underwent 3-D TRUS-guided prostate biopsies between April 2006 and November 2007 for prostate cancer detection. The indication for prostate biopsy was PSA > or = 4.0 ng/ml in 47 (69%) patients, abnormal digital rectal examination (DRE) in 17 (25%), and atypia on previous biopsy in 4 (6%) patients. Prostate cancer was detected in 18 patients (26.5%) and 7 (10.3%) had atypical small acinar proliferation (ASAP). The highest frequency (55.5%) from all cases of cancer detected was identified when 3-D TRUS biopsy was used as the initial biopsy. This study demonstrates that a 3-D TRUS-guided biopsy system translates to a more frequent detection of prostate cancer among patients undergoing an initial prostate biopsy than a subsequent one. More comprehensive studies are warranted to corroborate and extend the results of this study.
三维经直肠超声（TRUS）引导下的前列腺活检系统是一种新型设备，它能够以模板方式精确进行针穿刺。我们评估了其在前列腺癌（PCa）检测中的效用。进行了一项回顾性分析，评估了杜克前列腺中心68例接受三维TRUS引导系统前列腺活检的前瞻性患者。在创建前列腺的三维地图后，一种计算机算法根据测量的前列腺尺寸确定了理想的活检方案。然后，该系统使用固定模板，允许在特定位置进行前列腺活检，并且在需要时能够在未来靶向前列腺的同一区域。对于所有患者，采用12针活检模式覆盖前列腺底部、中叶和尖部的内侧和外侧区域。2006年4月至2007年11月期间，共有68例患者接受了三维TRUS引导下的前列腺活检以检测前列腺癌。前列腺活检的指征为：47例（69%）患者的前列腺特异性抗原（PSA）≥4.0 ng/ml，17例（25%）患者直肠指检（DRE）异常，4例（6%）患者既往活检有非典型性。18例患者（26.5%）检测到前列腺癌，7例（10.3%）有非典型小腺泡增生（ASAP）。当三维TRUS活检作为初次活检时，在所有检测到的癌症病例中发现的频率最高（55.5%）。这项研究表明，与后续活检相比，三维TRUS引导活检系统在接受初次前列腺活检的患者中能更频繁地检测到前列腺癌。需要进行更全面的研究来证实和扩展本研究的结果。
