Marien A, De Castro Abreu A, Gill I, Villers A, Ukimura O
Service d'urologie, hôpital Huriez, CHRU de Lille, 2, avenue Oscar-Lambret, 59037 Lille cedex, France.
Urology department, University of Southern California, Los Angeles, États-Unis.
Prog Urol. 2017 Sep;27(10):521-528. doi: 10.1016/j.purol.2017.05.013. Epub 2017 Jun 17.
The strategic therapy for prostate cancer depends on histo-pronostics data, which could be upgraded by obtaining targeted biopsies (TB) with MRI (magnetic resonance imagery) fusion 3D ultrasound.
To compare diagnostic yield of image fusion guided prostate biopsy using image fusion of multi-parametric MRI (mpMRI) with 3D-TRUS.
Between January 2010 and April 2013, 179 consecutive patients underwent outpatient TRUS biopsy using the real-time 3D TRUS tracking system (Urostation™). These patients underwent MRI-TRUS fusion targeted biopsies (TB) with 3D volume data of the MRI elastically fused with 3D TRUS at the time of biopsy.
A hundred and seventy-three patients had TBs with fusion. Mean biopsy core per patient were 11.1 (6-14) for SB and 2.4 (1-6) for TB. SBs were positive in 11% compared to 56% for TB (P<0.001). TB outperformed systematic biopsy(SB) in overall any cancer detection rate, detection of clinically significant cancer (58% vs. 36%), cancer core length (6.8mm vs. 2.8mm), and cancer rate per core (P<0.001). In multivariable logistic regression, with TB we have more chance to find a clinically significant cancer (OR:3.72 [2-6.95]). When both TRUS and MRI are positive, there is 2.73 more chance to find a clinically significant cancer.
MR/TRUS elastic fusion-guided biopsies outperform systematic random biopsies in diagnosing clinically significant cancer. Ability of interpretation of real-time TRUS is essential to perform the higher level of MR/US fusion and should be use for active surveillance.
前列腺癌的策略性治疗取决于组织预后数据，通过使用MRI（磁共振成像）融合3D超声进行靶向活检（TB）可对这些数据进行更新。
比较使用多参数MRI（mpMRI）与3D-TRUS的图像融合引导下前列腺活检的诊断率。
2010年1月至2013年4月期间，179例连续患者使用实时3D TRUS跟踪系统（Urostation™）接受门诊TRUS活检。这些患者在活检时接受了MRI-TRUS融合靶向活检（TB），将MRI的3D体积数据与3D TRUS进行弹性融合。
173例患者进行了融合活检。系统性活检（SB）每位患者的平均活检芯数为11.1（6 - 14），靶向活检（TB）为2.4（1 - 6）。SB的阳性率为11%，而TB为56%（P<0.001）。在总体任何癌症检测率、临床显著癌症检测率（58%对36%）、癌芯长度（6.8mm对2.8mm）以及每芯癌症发生率方面，TB均优于系统性活检（SB）（P<0.001）。在多变量逻辑回归中，采用TB我们有更多机会发现临床显著癌症（OR：3.72 [2 - 6.95]）。当TRUS和MRI均为阳性时，发现临床显著癌症的机会增加2.73倍。
MR/TRUS弹性融合引导下的活检在诊断临床显著癌症方面优于系统性随机活检。实时TRUS解释能力对于实现更高水平的MR/US融合至关重要，应将其用于主动监测。
4。
Zotero 插件