Shoji Sunao, Hiraiwa Shinichiro, Endo Jun, Hashida Kazunobu, Tomonaga Tetsuro, Nakano Mayura, Sugiyama Tomoko, Tajiri Takuma, Terachi Toshiro, Uchida Toyoaki
Department of Urology, Tokai University Hachioji Hospital, Tokyo, Japan.
Int J Urol. 2015 Feb;22(2):173-8. doi: 10.1111/iju.12643. Epub 2014 Oct 14.
To report our early experience with manually controlled targeted biopsy with real-time multiparametric magnetic resonance imaging and transrectal ultrasound fusion images for the diagnosis of prostate cancer.
A total of 20 consecutive patients suspicious of prostate cancer at the multiparametric magnetic resonance imaging scan were recruited prospectively. Targeted biopsies were carried out for each cancer-suspicious lesion, and 12 systematic biopsies using the BioJet system. Pathological findings of targeted and systematic biopsies were analyzed.
The median age of the patients was 70 years (range 52-83 years). The median preoperative prostate-specific antigen value was 7.4 ng/mL (range 3.54-19.9 ng/mL). Median preoperative prostate volume was 38 mL (range 24-68 mL). The number of cancer-detected cases was 14 (70%). The median Gleason score was 6.5 (range 6-8). Cancer-detected rates of the systematic and targeted biopsy cores were 6.7 and 31.8%, respectively (P < 0.0001). In six patients who underwent radical prostatectomy, the geographic locations and pathological grades of clinically significant cancers and index lesions corresponded to the pathological results of the targeted biopsies.
Prostate cancers detected by targeted biopsies with manually controlled targeted biopsy using real-time multiparametric magnetic resonance imaging and transrectal ultrasound fusion imaging have significantly higher grades and longer length compared with those detected by systematic biopsies. Further studies and comparison with the pathological findings of whole-gland specimens have the potential to determine the role of this biopsy methodology in patients selected for focal therapy and those under active surveillance.
报告我们使用实时多参数磁共振成像和经直肠超声融合图像进行手动控制靶向活检诊断前列腺癌的早期经验。
前瞻性招募了20例在多参数磁共振成像扫描中怀疑患有前列腺癌的连续患者。对每个可疑癌症病变进行靶向活检，并使用BioJet系统进行12次系统活检。分析靶向活检和系统活检的病理结果。
患者的中位年龄为70岁（范围52 - 83岁）。术前前列腺特异性抗原值的中位数为7.4 ng/mL（范围3.54 - 19.9 ng/mL）。术前前列腺体积的中位数为38 mL（范围24 - 68 mL）。检测到癌症的病例数为14例（70%）。Gleason评分的中位数为6.5（范围6 - 8）。系统活检核心和靶向活检核心的癌症检出率分别为6.7%和31.8%（P < 0.0001）。在6例接受根治性前列腺切除术的患者中，临床显著癌症和索引病变的地理位置及病理分级与靶向活检的病理结果相符。
与系统活检相比，使用实时多参数磁共振成像和经直肠超声融合图像进行手动控制靶向活检检测出的前列腺癌分级显著更高，长度更长。进一步的研究以及与全腺体标本病理结果的比较有可能确定这种活检方法在选择进行聚焦治疗的患者和接受主动监测的患者中的作用。
