The Diagnostic Yield of MRI-Transrectal US Fusion Prostate Biopsy in Patients With Suspected Prostate Cancer.

IF 3.7 3区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Ben Terry Thompson, Kiyana Kamali, Mohamed Abdolell, Michael Rivers-Bowerman, Andreu F Costa
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Abstract

Introduction: This study aimed to determine the positive predictive value (PPV) of magnetic resonance imaging-transrectal ultrasound (MRI-TRUS) machine fusion prostate biopsies, and to identify factors associated with a positive biopsy.

Methods: With ethics approval, we retrospectively evaluated all MRI-TRUS machine fusion prostate biopsies at our institution from September 2022 to April 2025. True positive clinically significant prostate cancers (csPCa) were defined as Gleason ≥7. PPVs were calculated overall and for PI-RADS 3, 4 and 5 categories. A generalized linear mixed model (GLMM) was created evaluating the following factors as fixed effects: PI-RADS category; prostate-specific antigen (PSA) density (<0.10, 0.10-0.15, ≥0.15 ng/mL2); lesion size (<7, 7-15, ≥15 mm); lesion location (peripheral vs transition zone); ultrasound correlate (present/absent); prostate size (<60 vs ≥60 mL); interval from MRI to biopsy (<6 months or not); and biopsy operator (2 radiologists). Referring urologist (n = 19) and reporting radiologist (n = 8) were included as random effects.

Results: 372 patients (mean age, 67 ± 7 years) with 529 lesions underwent biopsy. The overall PPV was 314/529 (59.4%). For PI-RADS 3 to 5, PPVs were 32/72 (44.4%), 123/243 (50.6%), and 159/214 (74.3%), respectively. In GLMM analysis, PI-RADS 5 versus 3 (OR 3.6, 95% CI, 1.7-7.4), PSA density ≥0.15 ng/mL2 (OR 2.2, 95% CI, 1.2-3.8), and presence of an ultrasound correlate (OR 2.7, 95% CI, 1.7-4.2) were associated with true positive biopsies. Small lesion size <7 mm was associated with a false positive biopsy (OR 0.4, 95% CI, 0.2-0.8).

Conclusion: The yield of fusion prostate biopsies at our institution is high. PI-RADS 5, PSA density ≥0.15 ng/mL2, and an ultrasound correlate at biopsy were associated with csPCa, whereas sub-7 mm lesions were negatively associated with csPCa.

mri经直肠US融合前列腺活检对疑似前列腺癌的诊断价值。
简介:本研究旨在确定磁共振成像-经直肠超声(MRI-TRUS)机器融合前列腺活检的阳性预测值(PPV),并确定活检阳性的相关因素。方法:经伦理批准,我们回顾性评估了2022年9月至2025年4月在我院进行的所有MRI-TRUS机器融合前列腺活检。真阳性临床显著性前列腺癌(csPCa)定义为Gleason≥7。计算ppv的整体和PI-RADS 3、4和5类。建立广义线性混合模型(GLMM),评价以下因素作为固定效应:PI-RADS类别;前列腺特异性抗原(PSA)密度(2);结果:372例患者(平均年龄67±7岁),529个病灶行活检。总PPV为314/529(59.4%)。PI-RADS 3 ~ 5的ppv分别为32/72(44.4%)、123/243(50.6%)和159/214(74.3%)。在GLMM分析中,PI-RADS 5比3 (OR 3.6, 95% CI, 1.7-7.4)、PSA密度≥0.15 ng/mL2 (OR 2.2, 95% CI, 1.2-3.8)和超声相关(OR 2.7, 95% CI, 1.7-4.2)与活检真阳性相关。结论:本院前列腺融合活检成功率高。PI-RADS 5, PSA密度≥0.15 ng/mL2,活检时超声相关与csPCa相关,而小于7 mm的病变与csPCa负相关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
6.20
自引率
12.90%
发文量
98
审稿时长
6-12 weeks
期刊介绍: The Canadian Association of Radiologists Journal is a peer-reviewed, Medline-indexed publication that presents a broad scientific review of radiology in Canada. The Journal covers such topics as abdominal imaging, cardiovascular radiology, computed tomography, continuing professional development, education and training, gastrointestinal radiology, health policy and practice, magnetic resonance imaging, musculoskeletal radiology, neuroradiology, nuclear medicine, pediatric radiology, radiology history, radiology practice guidelines and advisories, thoracic and cardiac imaging, trauma and emergency room imaging, ultrasonography, and vascular and interventional radiology. Article types considered for publication include original research articles, critically appraised topics, review articles, guest editorials, pictorial essays, technical notes, and letter to the Editor.
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