Direct Comparison of Targeted MRI-Guided Biopsy with Systematic Transrectal Ultrasound-Guided Biopsy in Patients with Previous Negative Prostate Biopsies

被引：40

作者：

Kaufmann, Sascha ^{[1
]}

Kruck, Stephan ^{[2
]}

Kramer, Ulrich ^{[1
]}

Gatidis, Sergios ^{[1
]}

Stenzl, Arnulf ^{[2
]}

Roethke, Matthias ^{[4
]}

Scharpf, Marcus ^{[3
]}

Schilling, David ^{[2
]}

机构：

[1] Univ Tubingen, Dept Radiol, Comprehens Canc Ctr CCC Tubingen, DE-72076 Tubingen, Germany

[2] Univ Tubingen, Dept Urol, Comprehens Canc Ctr CCC Tubingen, DE-72076 Tubingen, Germany

[3] Univ Tubingen, Dept Pathol, Comprehens Canc Ctr CCC Tubingen, DE-72076 Tubingen, Germany

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

来源：

UROLOGIA INTERNATIONALIS | 2015年 / 94卷 / 03期

关键词：

Prostate cancer; MRI-guided biopsy; Systematic transrectal ultrasound-guided biopsy; Diagnostic performance; CANCER-DETECTION RATE; ELASTOGRAPHY; DIAGNOSIS; STANDARD; IMPACT;

D O I：

10.1159/000365397

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：

Objective: To directly compare the diagnostic performance of targeted MRI-guided biopsy (MR-GB) and systematic transrectal ultrasound-guided biopsy (TRUS-GB). Methods: Thirty-five patients with at least one negative TRUS-GB, persistently elevated or rising prostate-specific antigen and a lesion suspicious for prostate cancer (PC) on multiparametric MRI (mpMRI) scored by using the Prostate Imaging Reporting and Data System (PI-RADS) were included. A median of three targeted biopsies per lesion were obtained and systematic TRUS-GB was performed subsequently by an independent urologist without knowledge of the MRI findings. Definite pathology reports were analyzed for anatomical location and criteria of clinical significance. Results: The tumor detection rate was significantly higher with MR-GB compared with TRUS-GB (16/35, 46% and 8/35, 23%, respectively, p < 0.05). MR-GB detected PC in all patients with positive TRUS-GB. All tumors detected by MR-GB exhibited at least one criterion of clinical significance. PC lesions showed a significantly higher PI-RADS sum score compared with benign lesions. Conclusions: MR-GB is more effective compared with TRUS-GB in detecting clinically significant PC in men after previous negative TRUS-GB. PI-RADS scores give additional information and could be part of the decision-making process when considering retrial biopsy. Additional systematic biopsy can be omitted in patients undergoing targeted MR-GB. (C) 2014 S. Karger AG, Basel

引用

页码：319 / 325

页数：7

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