Wu Jian, Xu Guang, Xiang Lihua, Guo Lehang, Wang Shuai, Dong Lin, Sun Liping
Department of Medical Ultrasound, Center of Minimally Invasive Treatment for Tumor, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, School of Medicine, Tongji University, Shanghai, 200072, China.
Department of Medical Ultrasound, Center of Minimally Invasive Treatment for Tumor, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, School of Medicine, Tongji University, No. 301, Yanchang Middle Road, Jing'an District, Shanghai, 200072, China.
Open Med (Wars). 2024 Oct 4;19(1):20241048. doi: 10.1515/med-2024-1048. eCollection 2024.
This retrospective study assessed the diagnostic accuracy of targeted biopsy (TB) and unilateral systematic biopsy in detecting clinically significant prostate cancer (csPCa) in 222 men with single magnetic resonance imaging (MRI) lesions (Prostate Imaging Reporting and Data System [PI-RADS] ≥ 3).
Patients underwent multiparametric MRI and MRI/ultrasound fusion TB and 12-needle standard biopsy (SB) from September 2016 to June 2021. The study compared the diagnostic performance of TB + iSB (ipsilateral), TB + contralateral system biopsy (cSB) (contralateral), and TB alone for csPCa using the test and analysis of variance.
Among 126 patients with csPCa (ISUP ≥ 2), detection rates for TB + iSB, TB + cSB, and TB were 100, 98.90, and 100% for lesions, respectively. TB + iSB showed the highest sensitivity and negative predictive value. No significant differences in accuracy were found between TB + iSB and the gold standard for type 3 lesions ( = 1). For types 4-5, detection accuracy was comparable across methods ( = 0.314, = 0.314, = 0.153). TB had the highest positive needle count rate, with TB + iSB being second for type 3 lesions (4.08% vs 6.57%, = 0.127).
TB + iSB improved csPCa detection rates and reduced biopsy numbers, making it a viable alternative to TB + SB for single MRI lesions.
本回顾性研究评估了靶向活检（TB）和单侧系统活检在检测222例具有单一磁共振成像（MRI）病变（前列腺影像报告和数据系统[PI-RADS]≥3）的男性患者中临床显著前列腺癌（csPCa）的诊断准确性。
2016年9月至2021年6月期间，患者接受了多参数MRI及MRI/超声融合TB和12针标准活检（SB）。该研究使用检验和方差分析比较了TB+iSB（同侧）、TB+对侧系统活检（cSB）（对侧）和单独TB对csPCa的诊断性能。
在126例csPCa（国际泌尿病理学会[ISUP]≥2）患者中，TB+iSB、TB+cSB和TB对病变的检出率分别为100%、98.90%和100%。TB+iSB显示出最高的敏感性和阴性预测值。TB+iSB与3型病变的金标准之间在准确性上未发现显著差异（=1）。对于4 - 5型，各方法的检测准确性相当（=0.314，=0.314，=0.153）。TB的阳性针数率最高，对于3型病变，TB+iSB次之（4.08%对6.57%，=0.127）。
TB+iSB提高了csPCa的检出率并减少了活检次数，使其成为单一MRI病变的TB+SB的可行替代方案。
