Zhang Kai, Zhang Zhipeng, Liu Ming, Zhu Gang, Roobol Monique J
Department of Urology, Erasmus University Medical Center, Rotterdam, The Netherlands.
Department of Urology, Beijing United Family Hospital and Clinics, Beijing 100015, China.
Transl Androl Urol. 2020 Apr;9(2):243-249. doi: 10.21037/tau.2020.02.20.
Multiparametric magnetic resonance imaging (mpMRI) targeted prostate biopsy increases the diagnostic accuracy of clinically significant prostate cancer (PCa). Currently there is no consensus on which type of MRI-targeted biopsy performs better in a given setting. In this study, we aimed to compare the detection rate of (clinically significant) PCa by MRI cognitive targeted biopsy (COG) and in-bore MRI-targeted biopsy (IB) techniques for naïve prostate biopsy patients in China.
Our study included 85 men from Beijing United Family Hospital and Clinics and 88 men from Beijing Hospital, National Center of Gerontology. All men had no history of prostate biopsy, undergoing mpMRI scan due to elevated PSA and/or abnormal DRE. The men in Beijing United Family Hospital group received COG plus systematic biopsy. The men in Beijing Hospital group only received IB.
The median age in COG and IB group was 63.0 years and 70.0 years (P<0.01). The median PSA was 7.4 and 6.8 ng/mL in COG and IB group respectively (P=0.124). The detection rate of PCa was 36.5% by COG and 52.3% by IB (P=0.037). The detection rate of clinically significant PCa (Gleason score ≥7) was 23.5% and 29.5% by COG and IB (P=0.371) respectively. In COG group, combination biopsy (COG + systematic biopsy) achieved improved PCa (42.4%) and clinically significant PCa (28.2%) detection rate compared with COG alone. However, there was no difference in overall PCa and clinically significant PCa detection between combination biopsy and IB.
IB had a higher rate of overall PCa detection compared with COG, but the two approaches did not differ significantly in the detection of clinically significant PCa. There was no significant difference in detection rate of PCa and clinically significant PCa between the combination biopsy and IB.
多参数磁共振成像（mpMRI）引导下的前列腺穿刺活检可提高临床显著性前列腺癌（PCa）的诊断准确性。目前，对于在特定情况下哪种类型的MRI引导下活检效果更佳尚无共识。在本研究中，我们旨在比较中国初诊前列腺穿刺活检患者中，MRI认知引导穿刺活检（COG）和内置MRI引导穿刺活检（IB）技术对（临床显著性）PCa的检出率。
我们的研究纳入了来自北京和睦家医院及诊所的85名男性和来自北京医院（国家老年医学中心）的88名男性。所有男性均无前列腺穿刺活检史，因PSA升高和/或直肠指检异常接受mpMRI扫描。北京和睦家医院组的男性接受COG联合系统穿刺活检。北京医院组的男性仅接受IB。
COG组和IB组的中位年龄分别为63.0岁和70.0岁（P<0.01）。COG组和IB组的中位PSA分别为7.4和6.8 ng/mL（P=0.124）。COG对PCa的检出率为36.5%，IB为52.3%（P=0.037）。COG和IB对临床显著性PCa（Gleason评分≥7）的检出率分别为23.5%和29.5%（P=0.371）。在COG组中，联合穿刺活检（COG + 系统穿刺活检）与单独使用COG相比，PCa（42.4%）和临床显著性PCa（28.2%）的检出率有所提高。然而，联合穿刺活检与IB在总体PCa和临床显著性PCa的检出方面并无差异。
与COG相比，IB的总体PCa检出率更高，但在临床显著性PCa的检出方面，两种方法并无显著差异。联合穿刺活检与IB在PCa和临床显著性PCa的检出率上无显著差异。
