Cetin Serhat, Huseyinli Arif, Koparal Murat Yavuz, Bulut Ender Cem, Ucar Murat, Gonul Ipek I, Sozen Sinan
Department of Urology, Gazi University Faculty of Medicine, Ankara, Turkey.
Department of Radiology, Gazi University Faculty of Medicine, Ankara, Turkey.
Prostate Int. 2023 Jun;11(2):122-126. doi: 10.1016/j.prnil.2023.01.003. Epub 2023 Jan 14.
The number of core biopsies required per region of interest (ROI) is controversial, as is the localization of the core to be taken from a lesion. This study aimed to determine the ideal biopsy core number and location in a multiparametric magnetic resonance imaging guided targeted prostate biopsy (TPB), without reducing the clinically significant prostate cancer (csPC) detection rate.
Data of patients who had PI-RADS ≥3 lesions on multiparametric magnetic resonance imaging and underwent a TPB in our clinic between October 2020 and January 2022 were reviewed, retrospectively. The first and second cores were taken from the central part of the ROI, whereas the third and fourth cores were taken from the right and left peripheries of the ROI. We compared the csPC detection success of single-, 2-, 3-, and 4-core samplings.
Software-based transrectal TPB was performed on 251 ROIs in a total of 167 patients. Internal Society of Urological Pathology Grade Group ≥2 cancer was detected in at least one core in 64 (25.4%) lesions. Moreover, csPC was detected in 42 (65.6%) ROIs in first-core biopsies; in 59 (92.2%) ROIs in first- and second-core biopsies; in 62 (96.9%) ROIs in first-, second-, and third-core biopsies; and in 64 (100%) ROIs in first-, second-, third-, and fourth-core biopsies. Using McNemar's test for comparison, a significant difference was found in terms of csPC detection success between performing first-core and second-core biopsies (65.6 - 92.2%, < 0.001); by contrast, no significant difference was observed in csPC detection success between 2-core and 3-core biopsies (92.2% - 96.9%, = 0.24). Furthermore, no significant difference existed between performing second-core and fourth-core biopsies in terms of csPC detection success (92.2%-100%, = 0.07).
We concluded that taking 2-core biopsies from the center of each ROIs during a transrectal TPB is sufficient for diagnosing csPC.
每个感兴趣区域（ROI）所需的穿刺活检核心样本数量存在争议，从病变部位获取核心样本的定位方式同样如此。本研究旨在确定多参数磁共振成像引导下的靶向前列腺穿刺活检（TPB）中理想的活检核心样本数量和位置，同时不降低临床显著性前列腺癌（csPC）的检出率。
回顾性分析2020年10月至2022年1月期间在我院接受TPB且多参数磁共振成像上PI-RADS≥3级病变的患者数据。第一和第二个核心样本取自ROI的中央部分，而第三和第四个核心样本取自ROI的右侧和左侧周边。我们比较了单核心、2核心、3核心和4核心采样对csPC的检测成功率。
共对167例患者的251个ROI进行了基于软件的经直肠TPB。64个（25.4%）病变的至少一个核心样本中检测到泌尿病理学会内部分级组≥2级癌症。此外，在第一核心活检中，42个（65.6%）ROI检测到csPC；在第一和第二核心活检中，59个（92.2%）ROI检测到csPC；在第一、第二和第三核心活检中，62个（96.9%）ROI检测到csPC；在第一、第二、第三和第四核心活检中，64个（100%）ROI检测到csPC。使用McNemar检验进行比较，在第一核心活检和第二核心活检之间，csPC检测成功率存在显著差异（65.6 - 92.2%，<0.001）；相比之下，2核心活检和3核心活检之间的csPC检测成功率未观察到显著差异（92.2% - 96.9%，=0.24）。此外，在第二核心活检和第四核心活检之间，csPC检测成功率也不存在显著差异（92.2% - 100%，=0.07）。
我们得出结论，经直肠TPB期间从每个ROI中心获取2个核心活检样本足以诊断csPC。
