Velez Erik, Fedorov Andriy, Tuncali Kemal, Olubiyi Olutayo, Allard Christopher B, Kibel Adam S, Tempany Clare M
Department of Radiology, Harvard Medical School, Brigham and Women's Hospital, National Center for Image Guided Therapy, 75 Francis St, Boston, MA, 02115, USA.
Division of Urology, Department of Surgery, Harvard Medical School, Brigham and Women's Hospital, 75 Francis St, Boston, MA, 02115, USA.
Abdom Radiol (NY). 2017 Aug;42(8):2154-2159. doi: 10.1007/s00261-017-1102-y.
To determine the accuracy of in-bore transperineal 3-Tesla (T) magnetic resonance (MR) imaging-guided prostate biopsies for predicting final Gleason grades in patients who subsequently underwent radical prostatectomy (RP).
A retrospective review of men who underwent transperineal MR imaging-guided prostate biopsy (tpMRGB) with subsequent radical prostatectomy within 1 year was conducted from 2010 to 2015. All patients underwent a baseline 3-T multiparametric MRI (mpMRI) with endorectal coil and were selected for biopsy based on MR findings of a suspicious prostate lesion and high degree of clinical suspicion for cancer. Spearman correlation was performed to assess concordance between tpMRGB and final RP pathology among patients with and without previous transrectal ultrasound (TRUS)-guided biopsies.
A total of 24 men met all eligibility requirements, with a median age of 65 years (interquartile range [IQR] 11.7). The median time from biopsy to RP was 85 days (IQR 50.5). Final pathology revealed Gleason 3 + 4 = 7 in 12 patients, 4 + 3 = 7 in 10 patients, and 4 + 4 = 8 in 2 patients. A strong correlation (ρ: +0.75, p < 0.001) between tpMRGB and RP results was observed, with Gleason scores concordant in 17 cases (71%). 16 of the 24 patients underwent prior TRUS biopsies. Subsequent tpMRGB revealed Gleason upgrading in 88% of cases, which was concordant with RP Gleason scores in 69% of cases (ρ: +0.75, p < 0.001).
Final Gleason scores diagnosed by tpMRGB at 3-T correlate strongly with final RP surgical pathology. This may facilitate prostate cancer diagnosis, particularly in patients with negative or low-grade TRUS biopsy results in whom clinically significant cancer is suspected or detected on mpMRI.
确定3特斯拉（T）磁共振（MR）成像引导下经会阴前列腺穿刺活检对随后接受根治性前列腺切除术（RP）患者最终Gleason分级预测的准确性。
对2010年至2015年期间接受经会阴MR成像引导下前列腺穿刺活检（tpMRGB）并在1年内接受根治性前列腺切除术的男性进行回顾性研究。所有患者均接受了使用直肠内线圈的基线3-T多参数MRI（mpMRI）检查，并根据可疑前列腺病变的MR表现和对癌症的高度临床怀疑选择进行活检。对有或无既往经直肠超声（TRUS）引导下活检的患者，采用Spearman相关性分析评估tpMRGB与最终RP病理结果之间的一致性。
共有24名男性符合所有入选标准，中位年龄为65岁（四分位间距[IQR]为11.7）。活检至RP的中位时间为85天（IQR为50.5）。最终病理显示，12例患者为Gleason 3 + 4 = 7，10例患者为4 + 3 = 7，2例患者为4 + 4 = 8。观察到tpMRGB与RP结果之间存在强相关性（ρ：+0.75，p < 0.001），17例（71%）患者的Gleason评分一致。24例患者中有16例曾接受过TRUS活检。随后的tpMRGB显示88%的病例中Gleason分级升高，其中69%的病例与RP Gleason评分一致（ρ：+0.75，p < 0.
