Diagnostic efficacy of targeted biopsy plus ipsilateral hemiglandular systematic biopsy of the dominant lesion in prostate cancer
10.3969/j.issn.1009-8291.2025.07.008
- VernacularTitle:靶向穿刺联合主病灶侧半腺系统穿刺对前列腺癌的诊断效能探索
- Author:
Yongsheng NIAN
1
;
Yongbing CHENG
;
Haifeng HUANG
;
Shan PENG
;
Jing LIANG
;
Hongqian GUO
;
Xuefeng QIU
Author Information
1. 南京大学医学院附属南京鼓楼医院泌尿外科,江苏南京 210008
- Publication Type:Journal Article
- Keywords:
prostate cancer;
magnetic resonance imaging;
targeted biopsy;
systematic biopsy;
clinically significant prostate cancer
- From:
Journal of Modern Urology
2025;30(7):593-598,602
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the diagnostic efficacy of targeted biopsy(TB)combined with ipsilateral hemiglandular systematic biopsy(SB)of the dominant lesion,so as to explore a novel reduced-core biopsy strategy.Methods A retrospective analysis was conducted on the clinical data of 299 patients treated in our hospital during Sep.1,2022,and Feb.28,2023,who had a Prostate Imaging Reporting and Data System(PI-RADS)score ≥3 and underwent combined TB and SB.The dominant lesion was defined as the lesion with the highest PI-RADS score on multi-parametric magnetic resonance imaging(mpMRI);in cases of identical scores,the largest was designated as the dominant.SB was categorized as ipsilateral(ipsi-SB)or contralateral(contra-SB)to the dominant lesion.The consistency in detecting clinically significant prostate cancer(csPCa)was compared between TB with ipsi-SB(TB+ipsi-SB),TB with contra-SB(TB+contra-SB),and TB with SB(TB+SB).Subgroup analyses were performed based on PI-RADS score,prostate-specific antigen(PSA)level,prostate volume(PV),and mpMRI lesion distribution to evaluate csPCa detection rates across different variables.Results TB+ipsi-SB demonstrated comparable detection rate to TB+SB(46.2％vs.46.8％).The K values for TB+ipsi-SB and TB+contra-SB relative to TB+SB were 0.987(95％CI:0.969-1.000,P＜0.01)and 0.933(95％CI:0.892-0.974,P＜0.01),respectively.Across all subgroups,TB+ipsi-SB showed the highest agreement with TB+SB.Notably,in subgroups with PI-RADS 3 and 5,PSA＞0-20 ng/mL,PV＜25 mL,bilateral or multiple mpMRI lesions,TB+ipsi-SB achieved complete concordance with TB+SB in csPCa detection[K=1.000(95％CI:1.000-1.000),P＜0.01].Conclusion For patients with PI-RADS score ≥3,TB+ipsi-SB exhibits near-perfect consistency with TB+SB in csPCa detection while requiring fewer biopsy cores.TB+ipsi-SB represents a promising refinement of the TB+SB approach.
