Department of Radiology, VKF American Hospital, Istanbul, Turkey.
Department of Urology, VKF American Hospital, Istanbul, Turkey.
Eur J Radiol. 2021 Aug;141:109785. doi: 10.1016/j.ejrad.2021.109785. Epub 2021 May 21.
To determine the diagnostic yield of magnetic resonance imaging (MRI) guided in-bore biopsy in patients with high likelihood multiparametric MRI (mpMRI) findings, regarding overall and clinically significant prostate cancer (csPCa) detection rates and concordance of biopsy and radical prostatectomy (RP) Gleason scores (GS).
This retrospective study consisted of 277 Prostate Imaging Reporting and Data System (PI-RADS) assessment category 4 and 5 targets in 246 patients (mean age, 65.7 years; median prostate specific antigen value, 7.75 ng/mL) who had undergone in-bore biopsy at our institution between 2012 and 2020. Eighty-one patients who underwent RP were eligible for the concordance analysis of biopsy and RP specimen GS.
Overall PCa detection rates were 80.5 % per patient (198/246) and 78 % per target (216/277) and 83.5 % and 67.4 % in primary (biopsy naive) and secondary (at least one negative prior biopsy) settings. csPCa was found in 63 % overall, 66 % of patients (132/200) in the primary, and 50 % of patients (23/46) in the secondary biopsy settings (p < 0.001). The prostate cancer detection rate was 68 % and 92 % in PI-RADS 4 and 5, respectively (p < 0.001). In the radical prostatectomy subcohort, 27.2 % of patients were upgraded, 8.6 % of patients were downgraded from needle biopsy. Significant complications occurred in 1.2 % of patients.
MRI-guided in-bore prostate biopsy has a high detection rate of csPCa in primary and secondary biopsy cohorts. Biopsy results were satisfactory in terms of the number of positive cores, cancer percentage in positive cores, and concordance of GS in needle biopsy and RP specimen.
确定高可能性多参数磁共振成像（mpMRI）发现的患者中磁共振成像（MRI）引导下腔内活检的诊断产量，关于整体和临床显著前列腺癌（csPCa）检测率以及活检和根治性前列腺切除术（RP）Gleason 评分（GS）的一致性。
本回顾性研究包括 246 名患者的 277 个前列腺成像报告和数据系统（PI-RADS）评估类别 4 和 5 目标（平均年龄 65.7 岁；中位前列腺特异性抗原值 7.75ng/ml），他们于 2012 年至 2020 年间在我们机构进行了腔内活检。81 名接受 RP 的患者符合活检和 RP 标本 GS 一致性分析的条件。
患者的总体 PCa 检出率为 80.5%（246/246）和 78%（277/277），主要（活检初治）和次要（至少一次阴性既往活检）设置的靶标为 83.5%和 67.4%。总体 csPCa 检出率为 63%，66%的患者（200/200）在主要组中，50%的患者（46/46）在次要活检组中（p<0.001）。PI-RADS 4 和 5 的前列腺癌检出率分别为 68%和 92%（p<0.001）。在根治性前列腺切除术亚组中，27.2%的患者升级，8.6%的患者从针活检降级。1.2%的患者发生了显著并发症。
MRI 引导下腔内前列腺活检在主要和次要活检组中具有较高的 csPCa 检出率。在阳性核心数量、阳性核心中癌症百分比以及针活检和 RP 标本 GS 的一致性方面，活检结果令人满意。
