Altay Mehmet Sefa, Özkaya Fatih, Demirdöğen Şaban Oğuz, Bedir Fevzi, Kocatürk Hüseyin, Cinislioğlu Ahmet Emre, Yilmaz Sinan, Yapanoğlu Turgut
Department of Urology, Health Sciences University, Erzurum Regional Training and Research Hospital, Erzurum, Turkey.
Department of Urology, Atatürk University School of Medicine, Erzurum, Turkey.
Eurasian J Med. 2022 Feb;54(1):12-16. doi: 10.5152/eurasianjmed.2022.20349.
This article aims to evaluate the efficacy of multiparametric magnetic resonance imaging before standard tru-cut biopsy in making prostate cancer diagnosis.
A total of 160 patients with prostate biopsy indications were prospectively evaluated between May 2017 and October 2018. Multiparametric magnetic resonance imaging was taken after obtaining a written informed consent from all patients. Cognitive transrectal ultrasound-guided biopsy was performed based on multiparametric magnetic resonance imaging results. Standard tru-cut biopsy was included to reduce false-negative rate. Statistical analysis was performed using the Statistical Package for Social Sciences version 20.0 software.
The mean age of the patients was 65.94 ± 7.90 (48-84) years. Around 19.37% of the patients had a specificity in the digital rectal exam. The mean prostate-specific antigen value of the patients with adenocarcinoma was 42.1 ng/mL and it was 10.2 ng/mL in patients with benign prostate hyperplasia. It was observed that the prostate-specific antigen values in prostatic adenocarcinomas were significantly higher than those in benign prostate hyperplasia (P < .001). The results of multiparametric magnetic resonance imaging and the biopsy were 100% similar in terms of zones in patients with adenocarcinoma. All of the biopsy results of the patients who were evaluated to have normal prostate tissue in multiparametric magnetic resonance imaging were evaluated as benign prostate hyperplasia; on the other hand, 13.6% of PI-RADS 2 lesions, 14% of PI-RADS 3 lesions, 31.8% of PI-RADS 4 lesions, and 85.7% of PI-RADS 5 lesions were determined to be adenocarcinoma. It was observed that the prevalence of adenocarcinoma increased as the risk elevated in multiparametric magnetic resonance imaging (P < .001).
Multiparametric magnetic resonance imaging evaluated by experienced radiologists may be instructive of urologists and reduce the need for unnecessary biopsies.
本文旨在评估标准粗针穿刺活检前多参数磁共振成像在前列腺癌诊断中的有效性。
2017年5月至2018年10月期间，对160例有前列腺活检指征的患者进行前瞻性评估。在获得所有患者的书面知情同意后，进行多参数磁共振成像检查。根据多参数磁共振成像结果进行认知经直肠超声引导下活检。纳入标准粗针穿刺活检以降低假阴性率。使用社会科学统计软件包20.0软件进行统计分析。
患者的平均年龄为65.94±7.90（48 - 84）岁。约19.37%的患者直肠指检有特异性表现。腺癌患者的平均前列腺特异性抗原值为42.1 ng/mL，良性前列腺增生患者为10.2 ng/mL。观察到前列腺腺癌患者的前列腺特异性抗原值显著高于良性前列腺增生患者（P <.001）。在腺癌患者中，多参数磁共振成像和活检结果在区域方面100%相似。多参数磁共振成像评估为前列腺组织正常的所有患者的活检结果均评估为良性前列腺增生；另一方面，PI-RADS 2类病变中有13.6%、PI-RADS 3类病变中有14%、PI-RADS 4类病变中有31.8%、PI-RADS 5类病变中有85.7%被确定为腺癌。观察到多参数磁共振成像中风险升高时腺癌的患病率增加（P <.001）。
由经验丰富的放射科医生评估的多参数磁共振成像可能对泌尿外科医生有指导作用，并减少不必要活检的需求。
