Department of Radiology, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; Cancer Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Cancer Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; Department of Urology, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Clin Radiol. 2019 Jun;74(6):474-479. doi: 10.1016/j.crad.2019.02.002. Epub 2019 Mar 4.
To evaluate the difference in prostate cancer detection rates according to lesion visibility using transrectal ultrasound (TRUS) and magnetic resonance imaging (MRI) before biopsy.
Patients who underwent TRUS-guided prostate biopsy in 2016 and 2017 (n=1,022) were divided into three groups: (1) patients who did not undergo a prebiopsy MRI (group 1, n=622); (2) patients without visible lesions on the prebiopsy MRI (group 2, n=77); and (3) patients with visible lesions on the prebiopsy MRI (group 3, n=323). Biopsy results were compared using chi-square tests or independent t-tests between patients with and without TRUS-visible lesions in each group. A logistic regression test was used to determine the variables independently associated with the detection of clinically significant cancer.
Focal lesions were visible on TRUS in 710 patients. Clinically significant cancers were detected in 39.4% and 13.1% of patients with and without TRUS-visible lesions, respectively (p<0.001). The cancer detection rate was significantly higher in patients with TRUS-visible lesions in groups 1 and 3 (p<0.001). Within group 1, the Gleason scores, number of positive cores, and the cancer involvement ratios were significantly greater in patients with TRUS-visible lesions than in patients without TRUS-visible lesions. MRI- and TRUS visibility were positively associated with the detection of clinically significant prostate cancer (p=0.002 and p<0.001, respectively).
TRUS- and MRI-visible focal lesions in the prostate were significantly associated with the detection of clinically significant cancer.
评估经直肠超声（TRUS）和磁共振成像（MRI）引导前列腺活检前根据病灶可见性检测前列腺癌的差异。
2016 年和 2017 年接受 TRUS 引导前列腺活检的患者（n=1022）分为三组：（1）未进行活检前 MRI 的患者（组 1，n=622）；（2）活检前 MRI 未见明显病灶的患者（组 2，n=77）；（3）活检前 MRI 可见病灶的患者（组 3，n=323）。各组中，通过卡方检验或独立 t 检验比较有和无 TRUS 可见病灶的患者活检结果。采用逻辑回归检验确定与检测临床显著癌相关的独立变量。
710 例患者在 TRUS 上可见局灶性病变。有和无 TRUS 可见病灶的患者中，临床显著癌的检出率分别为 39.4%和 13.1%（p<0.001）。组 1 和 3 中 TRUS 可见病灶的患者癌症检出率明显更高（p<0.001）。在组 1 中，与无 TRUS 可见病灶的患者相比，TRUS 可见病灶的患者的 Gleason 评分、阳性核心数和癌症累及率显著更高。MRI 和 TRUS 可见性与检测临床显著前列腺癌呈正相关（p=0.002 和 p<0.001）。
前列腺内 TRUS 和 MRI 可见的局灶性病变与检测临床显著癌症显著相关。
