Wang Hai-Feng, Chen Rui, He Bi-Ming, Qu Min, Wang Yan, Lin Heng-Zhi, Yang Qing-Song, Gao Xu, Sun Ying-Hao
Department of Urology, Shanghai Changhai Hospital, Second Military Medical University, Shanghai 200433, China.
Department of Radiology, Shanghai Changhai Hospital, Second Military Medical University, Shanghai 200433, China.
Asian J Androl. 2020 Jul-Aug;22(4):432-436. doi: 10.4103/aja.aja_83_19.
A cognitive magnetic resonance imaging (MRI)-targeted prostate biopsy conducted by an experienced clinician enhances the detection rate of (high-grade) prostate cancer; however, this method is less successful in the hands of inexperienced surgeons. Therefore, an alternative method of conducting a cognitive MRI-targeted biopsy that can be successfully performed by the inexperienced clinicians should be developed. Ninety-six males suspected of prostate cancer were analyzed using systematic biopsy and cognitive MRI-targeted biopsy based on our novel three-dimensional matrix positioning method. Typically, the core principle of the latter procedure was to put the MRI and ultrasound images into the same virtual coordinate system. Afterward, the targeted biopsy was transformed to target a coordinate for the suspected lesion in the MRI. Subsequently, patients were assessed for the presence/absence of prostate cancer or high-grade prostate cancer. According to our results, the overall detection rate of prostate cancer was 70.8% (68/96), and the detection rate of high-grade prostate cancer was 56.3% (54/96). Specifically, the detection rate of prostate cancer by systematic biopsy was 54.2% (52/96) and that by targeted biopsy was 59.4% (57/96; P = 0.560). Clearly, the combined application of targeted biopsy could remarkably increase the detection rates of prostate cancer (P = 0.025) and high-grade prostate cancer (P = 0.009). Taken together, the findings of this study suggest that the combination of systematic biopsy with our three-dimensional matrix positioning-driven cognitive-targeted biopsy is superior to systematic biopsy in detecting prostate cancer and high-grade prostate cancer.
由经验丰富的临床医生进行的认知磁共振成像（MRI）靶向前列腺活检可提高（高级别）前列腺癌的检出率；然而，这种方法在经验不足的外科医生手中成功率较低。因此，应开发一种可供经验不足的临床医生成功实施的认知MRI靶向活检替代方法。我们采用基于新型三维矩阵定位方法的系统活检和认知MRI靶向活检，对96名疑似前列腺癌的男性进行了分析。通常，后一种方法的核心原则是将MRI和超声图像放入同一虚拟坐标系。随后，将靶向活检转换为针对MRI中疑似病变的坐标。随后，对患者是否存在前列腺癌或高级别前列腺癌进行评估。根据我们的结果，前列腺癌的总体检出率为70.8%（68/96），高级别前列腺癌的检出率为56.3%（54/96）。具体而言，系统活检的前列腺癌检出率为54.2%（52/96），靶向活检的检出率为59.4%（57/96；P = 0.560）。显然，靶向活检的联合应用可显著提高前列腺癌（P = 0.025）和高级别前列腺癌（P = 0.009）的检出率。综上所述，本研究结果表明，系统活检与我们的三维矩阵定位驱动的认知靶向活检相结合在检测前列腺癌和高级别前列腺癌方面优于系统活检。
