Department of Urology, Korea University School of Medicine, Seoul, Korea.
Department of Radiology, Korea University School of Medicine, Seoul, Korea.
Cancer Res Treat. 2020 Jul;52(3):714-721. doi: 10.4143/crt.2019.716. Epub 2020 Feb 10.
The purpose of this study was to investigate the diagnostic value of magnetic resonance imaging (MRI)-ultrasound (US) fusion transperineal targeted biopsy (FTB) and fusion template systematic biopsy (FSB) for prostate cancer (PCa) and clinically significant prostate cancer (csPCa) (intermediate/high grade [Gleason score ≥ 3+4]) based on bi-parametric MRI (bpMRI).
Retrospectively, we analyzed 300 patients with elevated prostate-specific antigen (≥ 4.0 ng/mL) and/or abnormal findings in a digital rectal examination at the Korea University Hospital. All 300 men underwent bpMRI-US fusion transperineal FTB and FSB in the period from April 2017 to March 2019.
PCas were detected in 158 of 300 men (52.7%), and the prevalence of csPCa was 34.0%. CsPCas were detected in 12 of 102 (11.8%) with Prostate Imaging-Reporting and Data System (PI-RADS) 3, 42 of 92 (45.7%) with PI-RADS 4, respectively; and 45 of 62 (72.6%) men with PI-RADS 5, respectively. BpMRI showed a sensitivity of 95.1% and negative predictive value of 89.6% for csPCa. FTB detected additional csPCa in 33 men (12.9%) compared to FSB. Compared to FTB, FSB detected additional csPCa in 10 men (3.9%).
BpMRI-US FTB and FSB improved detection of PCa and csPCa. The accuracy of bi-parametric MRI is comparable with that of multi-parametric MRI. Further, it is rapid, simpler, cheaper, and no side effects of contrast media. Therefore, it is expected that bpMRI-US transperineal FTB and FSB could be a good alternative to conventional US-guided transrectal biopsy, which is the current gold standard.
本研究旨在探讨基于双参数 MRI（bpMRI）的磁共振成像（MRI）-超声（US）融合经会阴靶向活检（FTB）和融合模板系统活检（FSB）对前列腺癌（PCa）和临床显著前列腺癌（csPCa）（中/高级别[Gleason 评分≥3+4]）的诊断价值。
回顾性分析 2017 年 4 月至 2019 年 3 月在韩国大学医院因前列腺特异性抗原（PSA）升高（≥4.0ng/mL）和/或直肠指检异常而接受 bpMRI-US 融合经会阴 FTB 和 FSB 的 300 例患者。
300 例男性中 158 例（52.7%）检测到 PCa，csPCa 的患病率为 34.0%。PI-RADS 3 组中 12 例（11.8%）、PI-RADS 4 组中 42 例（45.7%）、PI-RADS 5 组中 62 例（72.6%）分别检测到 csPCa。bpMRI 对 csPCa 的灵敏度为 95.1%，阴性预测值为 89.6%。FTB 比 FSB 多检出 33 例（12.9%）csPCa。与 FTB 相比，FSB 多检出 10 例（3.9%）csPCa。
bpMRI-US FTB 和 FSB 提高了 PCa 和 csPCa 的检出率。双参数 MRI 的准确性与多参数 MRI 相当。此外，它快速、简单、便宜，没有对比剂的副作用。因此，预计 bpMRI-US 经会阴 FTB 和 FSB 可能成为传统超声引导经直肠活检的良好替代方法，后者是目前的金标准。
