ST4, Urology Department, St Richard Hospital, Chichester, UK.
Adv Exp Med Biol. 2018;1095:111-123. doi: 10.1007/978-3-319-95693-0_7.
Introduction The use of mutiparametric MRI (MpMRI) guided fusion biopsy is becoming an increasingly popular investigation in an aid to increase diagnostic yield in those suspected of having prostate cancer (PCa). Before adopting this technology, it is necessary to confirm the accuracy, so that PCa can be reliably diagnosed with characterisation. Materials and Methods This chapter analysed the evidences, which varied from well-designed randomised controlled trials to case series to detect the accuracy of MpMRI compared with biopsy/ histology. Results MpMRI incorporating T2 and diffusion weighted imaging only detects tumours in around 92% cases. When dynamic contrast enhancement is added, cancer diagnosis is significantly improved. Fusion biopsy increases the detection of high-risk PCa by 32% over conventional biopsy alone. Conclusion This review also revealed that fusion biopsy did not increase cancer detection rate but combined biopsy (Systematic and fusion) provide the highest detection rate for the diagnosis of PCa.
简介 多参数 MRI（mpMRI）引导下融合活检在辅助诊断前列腺癌（PCa）方面的应用越来越受到关注，以提高诊断率。在采用这项技术之前，需要确认其准确性，以便可靠地诊断 PCa 并进行特征描述。 材料与方法 本章分析了各种证据，包括精心设计的随机对照试验和病例系列，以检测 mpMRI 与活检/组织学相比的准确性。 结果 仅结合 T2 和扩散加权成像的 mpMRI 可检测到约 92%的肿瘤。当加入动态对比增强时，癌症诊断的准确性显著提高。与单纯常规活检相比，融合活检可将高危 PCa 的检出率提高 32%。 结论 本综述还表明，融合活检并未提高癌症检出率，但联合活检（系统和融合）可提供最高的 PCa 诊断检出率。
