Oderda Marco, Calleris Giorgio, Dematteis Alessandro, Greco Alessandro, Marquis Alessandro, Marra Giancarlo, Merani Umberto, Sasia Alberto, Venturi Alessio, Zitella Andrea, Gontero Paolo
Division of Urology, Department of Surgical Sciences, Molinette Hospital, University of Turin, 10126 Torino, Italy.
Cancers (Basel). 2025 Jul 18;17(14):2381. doi: 10.3390/cancers17142381.
: prostate fusion biopsies are key in the diagnosis of prostate cancer (PCa); however, the fusion imaging system is not always user-friendly or reliable. The aim of this study was to assess the feasibility, accuracy, and effectiveness of transperineal fusion biopsies performed with a novel fusion imaging device equipped with AI-driven auto-contouring. : data from 148 patients who underwent MRI-targeted and systematic prostate fusion biopsy with UroFusion (Esaote) were prospectively collected. All biopsies were performed in-office, under local anaesthesia. : cancer detection rate was 64% overall and 56% for clinically significant PCa (csPCa, ISUP ≥ 2). PCa was detected in 35%, 65% and 84% of lesions scored as PI-RADS 3, 4 and 5, respectively. Outfield positive systematic cores were found in the contralateral lobe in one third of cases. Median device-time to obtain fusion imaging was 5 min and median biopsy duration was 15 min. Median difference in volume estimation between ultrasound and MRI auto-contouring was only 1 cc. Detection rate did not differ between experienced and novice, supervised users. : in this initial prospective experience, fusion biopsies performed with UroFusion AI-driven auto-contouring system appeared time-efficient, accurate, well tolerated, and user-friendly, with comparable outcomes between experienced and novice users. Systematic biopsies remain highly recommended given the non-negligible rates of positive outfield cores.
前列腺融合活检是前列腺癌（PCa）诊断的关键；然而，融合成像系统并不总是用户友好或可靠的。本研究的目的是评估使用配备人工智能驱动自动轮廓的新型融合成像设备进行经会阴融合活检的可行性、准确性和有效性。前瞻性收集了148例接受UroFusion（Esaote）磁共振成像靶向和系统性前列腺融合活检患者的数据。所有活检均在办公室局部麻醉下进行。总体癌症检出率为64%，临床显著前列腺癌（csPCa，ISUP≥2）的检出率为56%。在PI-RADS评分为3、4和5的病变中，分别有35%、65%和84%检测到前列腺癌。三分之一的病例在对侧叶发现了外场阳性系统性活检组织。获得融合成像的设备中位时间为5分钟，活检中位持续时间为15分钟。超声和磁共振成像自动轮廓之间的体积估计中位差异仅为1立方厘米。经验丰富的用户和新手、有监督的用户之间的检测率没有差异。在这项初步的前瞻性研究中，使用UroFusion人工智能驱动自动轮廓系统进行的融合活检似乎省时、准确、耐受性好且用户友好，经验丰富的用户和新手用户之间的结果相当。鉴于外场阳性活检组织的发生率不可忽视，仍强烈建议进行系统性活检。
