Department of Urology, Thomayer Hospital and 3rd Faculty of Medicine, Charles University, Prague, Czech Republic.
Department of Urology, 1.
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2020 Sep;164(3):314-319. doi: 10.5507/bp.2019.050. Epub 2019 Oct 10.
Software-based MRI/TRUS fusion biopsy depends on the coordination of several steps, and inter-examiner differences could influence the results. The aim of this bicentric prospective study was to compare the detection rates of MRI/TRUS fusion targeted biopsy (TG) and systematic biopsy (SB), and the detection rates of examiners with different levels of previous experience in prostate biopsy.
A total of 419 patients underwent MRI based on a suspicion of prostate cancer with elevated PSA levels. MRI was positive in 395 patients (221 in the first biopsy group [FB] and 174 in the repeated biopsy group [RB]). A subsequent TG, followed by a SB, was performed on these patients by four different examiners.
In the detection of clinically significant prostate cancer, a significant difference was found for TG+SB against SB in the RB group (35.1% vs. 25.3%, P=0.047). In the detection of clinically insignificant prostate cancer, the SB had a significantly higher detection rate than TG in both subgroups (FB: 11.9% vs. 4.7%, P=0.008; RB: 13.8% vs. 6.9%, P=0.034). A significant difference was found between the four examiners in the FB for TG (P=0.028), SB (P=0.036), and TG+SB (P=0.017).
MRI/TRUS TG in combination with SB had significantly higher detection rates than SB in the RB group only. Differences in detection rates between examiners were dependent on the level of previous experience with TRUS guided biopsy.
基于软件的 MRI/TRUS 融合活检依赖于多个步骤的协调，而检查者之间的差异可能会影响结果。本项双中心前瞻性研究的目的是比较 MRI/TRUS 融合靶向活检（TG）和系统活检（SB）的检出率，以及在前列腺活检方面具有不同既往经验的检查者的检出率。
共 419 例患者因 PSA 水平升高接受 MRI 检查，怀疑患有前列腺癌。395 例患者 MRI 阳性（首次活检组 [FB] 221 例，重复活检组 [RB] 174 例）。对这些患者进行了 TG，随后进行了 SB，由四位不同的检查者进行。
在检测临床上显著的前列腺癌时，RB 组 TG+SB 与 SB 之间存在显著差异（35.1%比 25.3%，P=0.047）。在检测临床上不显著的前列腺癌时，SB 在两个亚组中的检出率均明显高于 TG（FB：11.9%比 4.7%，P=0.008；RB：13.8%比 6.9%，P=0.034）。在 FB 中，四位检查者在 TG（P=0.028）、SB（P=0.036）和 TG+SB（P=0.017）方面存在显著差异。
MRI/TRUS TG 联合 SB 在 RB 组的检出率明显高于 SB。检查者之间的检出率差异取决于 TRUS 引导活检的既往经验水平。
