Ben Terry Thompson, Kiyana Kamali, Mohamed Abdolell, Michael Rivers-Bowerman, Andreu F Costa
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引用次数: 0
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.
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.