Assessment of free-hand transperineal targeted prostate biopsy using multiparametric magnetic resonance imaging-transrectal ultrasound fusion in Chinese men with prior negative biopsy and elevated prostate-specific antigen

被引:20
作者
Lian, Huibo [1 ,4 ]
Zhuang, Junlong [1 ,4 ]
Wang, Wei [1 ,4 ]
Zhang, Bing [2 ]
Shi, Jiong [3 ]
Li, Danyan [2 ]
Fu, Yao [3 ]
Jiang, Xuping [5 ]
Zhou, Weimin [5 ]
Guo, Hongqian [1 ,4 ]
机构
[1] Nanjing Univ, Drum Tower Hosp, Med Sch, Dept Urol, 321 Zhongshan Rd, Nanjing 210008, Jiangsu, Peoples R China
[2] Nanjing Univ, Drum Tower Hosp, Med Sch, Dept Radiol, 321 Zhongshan Rd, Nanjing 210008, Jiangsu, Peoples R China
[3] Nanjing Univ, Drum Tower Hosp, Med Sch, Dept Pathol, 321 Zhongshan Rd, Nanjing 210008, Jiangsu, Peoples R China
[4] Nanjing Univ, Inst Urol, Nanjing 210008, Jiangsu, Peoples R China
[5] Jiangsu Univ, Affiliated Yixing Peoples Hosp, Dept Urol, Yixing 212000, Jiangsu, Peoples R China
来源
BMC UROLOGY | 2017年 / 17卷
关键词
Magnetic resonance imaging; Prostate cancer; Repeat biopsy; Targeted biopsy; Transrectal ultrasound; SCREENING TRIAL; GUIDED BIOPSY; TUMOR VOLUME; CANCER; DIAGNOSIS; SYSTEM;
D O I
10.1186/s12894-017-0241-3
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: To evaluate the role of free-hand transperineal targeted prostate biopsy using multiparametric magnetic resonance imaging-transrectal ultrasound (mpMRI-TRUS) fusion in Chinese men with repeated biopsy. Methods: A total of 101 consecutive patients suspicious of prostate cancer (PCa) at the mpMRI scan and with prior negative biopsy and elevated PSA values were prospectively recruited at two urological centers. Suspicious areas on mpMRI were defined and graded using PI-RADS score. Targeted biopsies (TB) were performed for each suspicious lesion and followed a 12-core systematic biopsy (SB). Results of biopsy pathology and whole-gland pathology at prostatectomy were analyzed and compared between TB and SB. The risk for biopsy positivity was assessed by univariate and multivariate logistic regression analysis. Results: Fusion biopsy revealed PCa in 41 of 101 men (40.6%) and 25 (24.8%) were clinically significant. There was exact agreement between TB and SB in 74 (73.3%) men. TB diagnosed 36% more significant cancer than SB (22 vs 13 cases, P = 0.012). When TB were combined with SB, an additional 14 cases (34.1%) of mostly significant PCa (71.4%) were diagnosed (P = 0.036). TB had greater sensitivity and accuracy for significant cancer than SB in 26 men with whole-gland pathology after prostatectomy. PI-RADS score on mpMRI was the most powerful predictor of PCa and significant cancer. Conclusions: Free-hand transperineal TB guided with MRI-TRUS fusion imaging improves detection of clinical significant PCa in Chinese men with previously negative biopsy. PI-RADS score is a reliable predictor of PCa and significant cancer.
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页数:7
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