Free-hand transperineal multiparametric magnetic resonance imaging/transrectal ultrasound fusion-guided targeted biopsy for the diagnosis of prostate cancer: a prospective study
10.3760/cma.j.issn.1000-6702.2018.03.009
- VernacularTitle:自由臂经会阴多参数磁共振-超声影像融合引导靶向穿刺诊断前列腺癌的前瞻性研究
- Author:
Wei WANG
1
;
Qing ZHANG
;
Bing ZHANG
;
Jiong SHI
;
Yao FU
;
Danyan LI
;
Xuefeng QIU
;
Haifeng HUANG
;
Xiaoyu LYU
;
Hongqian GUO
Author Information
1. 210008,南京大学医学院附属鼓楼医院泌尿外科 南京大学泌尿外科学研究所
- Keywords:
Magnetic resonance imaging;
Prostate cancer;
Fusion image;
Biopsy;
Risk stratification
- From:
Chinese Journal of Urology
2018;39(3):192-196
- CountryChina
- Language:Chinese
-
Abstract:
Objective To assess the value of free-hand transperineal multiparametric nagnetic resonance imaging/transrectal ultrasound (mpMRI/TRUS) fusion-guided targeted biopsy (TB) for the diagnosis of prostate cancer(PCa).Methods Patients with elevated PSA level and/or an abnormal DRE finding were recruited prospectively between January 2015 and September 2016.Patients were classified to various scores from 2 to 5 according to prebiopsy mpMRI PI-RADS.Based on free-hand transperineal mpMRI/TRUS fusion-guiding,a 2-cores TB for each cancer-suspicious lesion were carried out and followed 12-cores systematic biopsy (SB) protocol.Pathological findings of biopsy and radical prostatectomy (RP) specimens were analyzed.Results A total of 397 patients were enrolled in this study.The median age of the patients was (68.2 ± 7.4) years old,ranging 42-78 years.The median PSA level was (15.0 ±12.4)ng/ml,ranging 3.0-88.3 ng/ml.DRE showed abnormality in 28 patients(7.1％).The median prostate volume was (41.6 ± 16.4)cm3,ranging 24.6-89.8 cm3.The PCa detection rate of TB was significantly increased compared with SB (44.8 ％ vs.34.8％) (P =0.003),especially in clinically significant PCa (P ＜ 0.001) and intermediate/high-risk PCa (P =0.003),respectively.Of the all 588 mpMRI targeted lesions,277 lesions were positive.A total of 105 index tumors were identified in RP specimens,the locations of TB-proven cancer showed 96.6％ (85/88) in correspondence with the location of the index lesion in RP specimens.Conclusions Free-hand transperineal mpMRI/TRUS fusion-guided TB providing greater detection of intermediate-high risk PCa while limits over detection of low risk PCa.Moreover,TB can reliably predict the location of an index tumor.
