Detection of Significant Prostate Cancer Using Target Saturation in Transperineal Magnetic Resonance Imaging/Transrectal Ultrasonography-fusion Biopsy

被引：46

作者：

Tschirdewahn, Stephan ^{[1
]}

Wiesenfarth, Manuel ^{[2
]}

Bonekamp, David ^{[3
]}

Puellen, Lukas ^{[1
]}

Reis, Henning ^{[4
]}

Panic, Andrej ^{[1
]}

Kesch, Claudia ^{[1
]}

Darr, Christopher ^{[1
]}

Hess, Jochen ^{[1
]}

Giganti, Francesco ^{[5
,6
]}

Moore, Caroline M. ^{[6
,7
]}

Guberina, Nika ^{[8
]}

Forsting, Michael ^{[8
]}

Wetter, Axel ^{[8
]}

Hadaschik, Boris ^{[1
]}

Radtke, Jan Philipp ^{[1
,3
]}

机构：

[1] Univ Hosp Essen, Dept Urol, Hufelandstr 55, D-45147 Essen, Germany

[2] German Canc Res Ctr, Div Biostat, Heidelberg, Germany

[3] German Canc Res Ctr, Dept Radiol, Heidelberg, Germany

[4] Univ Duisburg Essen, Inst Pathol, Essen, Germany

[5] Univ Coll London Hosp NHS Fdn Trust, Dept Radiol, London, England

[6] UCL, Div Surg & Intervent Sci, London, England

[7] Univ Coll London Hosp NHS Fdn Trust, Dept Urol, London, England

[8] Univ Hosp Essen, Inst Diagnost & Intervent Radiol, Essen, Germany

来源：

EUROPEAN UROLOGY FOCUS | 2021年 / 7卷 / 06期

关键词：

Prostate cancer; Magnetic resonance imaging; Targeted biopsy; Target saturation; transrectal ultrasound fusion; Detection accuracy of target; saturation biopsy; DIAGNOSTIC-ACCURACY; MRI;

D O I：

10.1016/j.euf.2020.06.020

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

Background: Multiparametric magnetic resonance imaging (mpMRI) and targeted biopsies (TBs) facilitate accurate detection of significant prostate cancer (sPC). However, it remains unclear how many cores should be applied per target. Objective: To assess sPC detection rates of two different target-dependent magnetic resonance imaging (MRI)/transrectal ultrasonography (TRUS)-fusion biopsy approaches (TB and target saturation [TS]) compared with extended systematic biopsies (SBs). Design, setting, and participants: Retrospective single-centre outcome of transperineal MRI/TRUS-fusion biopsies of 213 men was evaluated. All men underwent TB with a median of four cores per MRI lesion, followed by a median of 24 SBs, performed by experienced urologists. Cancer and sPC (International Society of Urological Pathology grade group 2) detection rates were analysed. TB was compared with SB and TS, with nine cores per target, calculated by the Ginsburg scheme and using individual cores of the lesion and its "penumbra". Outcome measurements and statistical analysis: Cancer detection rates were calculated for TS, TB, and SB at both lesion and patient level. Combination of SB + TB served as a reference. Statistical differences in prostate cancer (PC) detection between groups were calculated using McNemar's tests with confidence intervals. Results and limitations: TS detected 99% of 134 sPC lesions, which was significantly higher than the detection by TB (87%, p = 0.001) and SB (82%, p < 0.001). SB detected significantly more of the 72 low-risk PC lesions than TB (99% vs 68%, p < 0.001) and 10% (p = 0.15) more than that detected by TS. At a per-patient level, 99% of men harbouring sPC were detected by TS. This was significantly higher than that by TB and SB (89%, p = 0.03 and 81%, p = 0.001, respectively). Limitations include limited generalisability, as a transperineal biopsy route was used.

引用

页码：1300 / 1307

页数：8

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