Uno Hiromi, Taniguchi Tomoki, Seike Kensaku, Kato Daiki, Takai Manabu, Iinuma Koji, Horie Kengo, Nakane Keita, Koie Takuya
Department of Urology, Chuno Kosei Hospital, Seki, Japan.
Department of Urology, Gifu University Graduate School of Medicine, Gifu, Japan.
Transl Androl Urol. 2021 Jul;10(7):2982-2989. doi: 10.21037/tau-21-250.
This study aimed to estimate whether multiparametric magnetic resonance imaging (mpMRI)-transrectal ultrasound (TRUS) fusion biopsy (FUS-TB) increases the detection rates of clinically significant prostate cancer (csPCa) compared with TRUS-guided systematic biopsy (TRUS-GB).
This retrospective study focused on patients who underwent mpMRI before prostate biopsy (PB) with Prostate Imaging Reporting and Data System version 2 (PI-RADS v2) scores ≥3 and prostate-specific antigen (PSA) level between 2.5 and 20 ng/mL. Before FUS-TB, the biopsy needle position was checked virtually using three-dimensional mapping. After confirming the position of the target within the prostate, biopsy needle was inserted and PB was performed. Suspicious lesions were generally targeted with 2 to 4 cores. Subsequently, 10-12 cores were biopsied for TRUS-GB. The primary endpoint was the PCa detection rate (PCDR) for patients with PCa who underwent combined FUS-TB and TRUS-GB.
According to PI-RADS v2, 76.7% of the patients with PI-RADS v2 score ≥3 were diagnosed with PCa. The PCDRs in patients with PI-RADS v2 score of 4 or 5 were significantly higher than those in patients with PI-RADS v2 score of 3 (3 . 4, P<0.001; 3 . 5, P<0.001; 4 . 5, P=0.073). According to PCDR, the detection rates of PCa and csPCa in the FUS-TB were significantly higher than that in the TRUS-GB.
Following detection of suspicious tumor lesions on mpMRI, FUS-TB use detects a higher number of PCa cases compared with TRUS-GB.
本研究旨在评估多参数磁共振成像（mpMRI）-经直肠超声（TRUS）融合活检（FUS-TB）与TRUS引导下系统活检（TRUS-GB）相比，是否能提高临床显著性前列腺癌（csPCa）的检出率。
本回顾性研究聚焦于前列腺活检（PB）前接受mpMRI检查、前列腺影像报告和数据系统第2版（PI-RADS v2）评分≥3且前列腺特异性抗原（PSA）水平在2.5至20 ng/mL之间的患者。在进行FUS-TB之前，使用三维映射虚拟检查活检针位置。在确认前列腺内目标位置后，插入活检针并进行PB。可疑病变通常取2至4针活检。随后，对TRUS-GB取10至12针活检。主要终点是接受FUS-TB和TRUS-GB联合检查的前列腺癌患者的前列腺癌检出率（PCDR）。
根据PI-RADS v2，PI-RADS v2评分≥3的患者中有76.7%被诊断为前列腺癌。PI-RADS v2评分为4或5的患者的PCDR显著高于PI-RADS v2评分为3的患者（3.4，P<0.001；3.5，P<0.001；4.5，P=0.073）。根据PCDR，FUS-TB中前列腺癌和csPCa的检出率显著高于TRUS-GB。
在mpMRI上检测到可疑肿瘤病变后，与TRUS-GB相比，使用FUS-TB能检测出更多前列腺癌病例。
