Sandahl Mads, Sandahl Kristian Juul, Marinovskij Edvard, Nielsen Tomas Frahm, Sørensen Karina Dalsgaard, Borre Michael, Ulhøi Benedicte Parm, Pedersen Bodil Ginnerup
Department of Radiology, Aarhus University Hospital, Aarhus, Denmark.
Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
Eur Urol Open Sci. 2022 May 28;41:88-94. doi: 10.1016/j.euros.2022.05.002. eCollection 2022 Jul.
The diagnostic efficacy regarding prostate cancer (PC) detection by manually operated in-bore magnetic resonance imaging (MRI) targeted prostate biopsy (MO-MRGB) versus robot-assisted in-bore MRI targeted prostate biopsy (RA-MRGB) is lacking evidence.
We hypothesized that the detection rates (DRs) for PC of MO-MRGB and RA-MRGB were similar and aimed to compare these.
We prospectively included all patients who received in-bore MRI targeted prostate biopsy (MRGB) of the prostate in the Central Denmark Region from August 2014 to February 2020. From August 2014, MO-MRGB was used, and from March 2018, RA-MRGB was preferred. Referral to in-bore MRGB was based on multiparametric MRI (mpMRI).
We compared PC DRs of MO-MRGB and RA-MRGB with Pearson's chi-square test. We made three binary regression models and calculated the risk difference (RD) of PC between the in-bore MRGB systems.
A total of 3107 patients were referred to mpMRI, and 884 (28%) patients went on to receive in-bore MRGB. The MO-MRGB and RA-MRGB systems were used in 505 (57%) and 379 (43%) patients, respectively. Taking clinically relevant covariates into account, we found no statistically significant difference in PC DRs between MO-MRGB and RA-MRGB (72% vs 73%, RD 1%, 95% confidence interval -4% to 7%, = 0.6). The main limitation was a shift in population characteristics.
We did not see evidence of an effect on the DR or the RD for PC when we compared MO-MRGB with RA-MRGB. Cost effectiveness should be considered carefully when choosing the MRGB system.
We compared two magnetic resonance imaging guided prostate tissue sampling systems regarding prostate cancer (PC) detection. One system was manually operated, and the other system was robot assisted. Comparing the systems, we found no evidence of a difference in their ability to detect PC.
关于手动操作的腔内磁共振成像（MRI）靶向前列腺活检（MO - MRGB）与机器人辅助的腔内MRI靶向前列腺活检（RA - MRGB）在检测前列腺癌（PC）方面的诊断效能，目前缺乏证据。
我们假设MO - MRGB和RA - MRGB对PC的检测率（DRs）相似，并旨在对二者进行比较。
设计、设置与参与者：我们前瞻性纳入了2014年8月至2020年2月在丹麦中部地区接受前列腺腔内MRI靶向前列腺活检（MRGB）的所有患者。从2014年8月起使用MO - MRGB，从2018年3月起更倾向于使用RA - MRGB。腔内MRGB的转诊基于多参数MRI（mpMRI）。
我们使用Pearson卡方检验比较了MO - MRGB和RA - MRGB的PC DRs。我们构建了三个二元回归模型，并计算了腔内MRGB系统之间PC的风险差异（RD）。
共有3107例患者接受了mpMRI检查，其中884例（28%）患者继续接受了腔内MRGB检查。MO - MRGB和RA - MRGB系统分别应用于505例（57%）和379例（43%）患者。考虑到临床相关协变量，我们发现MO - MRGB和RA - MRGB之间的PC DRs无统计学显著差异（72%对73%，RD为1%，95%置信区间为 - 4%至7%，P = 0.6）。主要局限性是人群特征的变化。
当我们比较MO - MRGB与RA - MRGB时，未发现对PC的DR或RD有影响的证据。选择MRGB系统时应仔细考虑成本效益。
我们比较了两种磁共振成像引导的前列腺组织采样系统在检测前列腺癌（PC）方面的情况。一种系统是手动操作的，另一种系统是机器人辅助的。比较这两种系统，我们没有发现它们在检测PC能力上存在差异的证据。
