The accuracy of transperineal template-guided mapping biopsy in patients with negative magnetic resonance imaging

IF 4 2区医学 Q2 UROLOGY & NEPHROLOGY

Prostate International Pub Date : 2026-06-01 Epub Date: 2026-02-14 DOI:10.1016/j.prnil.2026.02.001

Liang-yong Zhu, Cheng-hao Guo, Min Fang, Sheng-ming Lu, Yang Luan, Tian-bao Huang, Xiao Tan, Xue-fei Ding

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Abstract

Background

The aim of this study was to assess the diagnostic accuracy and spatial localization capability of transperineal template-guided mapping biopsy (TTMB) in the detection of prostate cancer in patients with negative magnetic resonance imaging (MRI).

Materials and methods

A retrospective study was conducted to analyze the clinical data and follow-up outcomes of patients with negative MRI who underwent transperineal prostate biopsy at Northern Jiangsu People's Hospital, between January 2017 and August 2020. The patients were categorized into TTMB group and the systematic biopsy (SB) group according to the biopsy method. The biopsy positivity rate, detection rate of clinically significant prostate cancer (csPCa), pathological grade upgrading and downgrading following radical surgery, repeat biopsy rate, and positive rate of repeat biopsy were compared between the two patient groups. The diagnostic accuracy of TTMB in detecting and localizing prostate lesions was assessed using whole-mount radical prostatectomy specimens.

Results

A total of 398 patients were enrolled in the study, of whom 185 were in the TTMB group and 213 in the SB group. The TTMB group had significantly higher biopsy cores (53.5 vs. 18.1), biopsy-positive rate [28.1% (52/185) vs. 15.5% (33/213)], and csPCa rate [15.7% (29/185) vs. 8.9% (19/213)] than the SB group. In radical prostatectomy, compared with SB, the pathological downgrade of TTMB was higher (36.4% vs. 19.2%), and the pathological upgrade was lower (6.8% vs. 30.8%). The incidence of hematuria (37.8%), perineal hematoma (34%), and urinary retention (11.9%) in TTMB is significantly higher than in SB (P < 0.05). The repeat biopsy rate (13.2%) and the csPCa detection rate (2.5%) in the TTMB group were both significantly lower than in the SB group (28.1% and 9.9). Whole-mount histopathological revealed 118 lesions, and 91.5% (108/118) lesions were detected by TTMB.

Conclusions

TTMB enhances biopsy accuracy and facilitates more precise detection and evaluation of tumor lesions patients with negative MRI.

查看原文本刊更多论文

经会阴模板引导穿刺活检在磁共振阴性患者中的准确性。

背景：本研究的目的是评估经会阴模板引导穿刺活检（TTMB）对阴性磁共振成像（MRI）患者前列腺癌的诊断准确性和空间定位能力。材料与方法：回顾性分析2017年1月至2020年8月在苏北人民医院行经会阴前列腺活检的MRI阴性患者的临床资料及随访结果。根据活检方法将患者分为TTMB组和系统活检（SB）组。比较两组患者的活检阳性率、临床显著性前列腺癌（csPCa）检出率、根治性手术后病理分级升级与降级、重复活检率、重复活检阳性率。TTMB在检测和定位前列腺病变方面的诊断准确性通过全坐骑根治性前列腺切除术标本进行评估。结果：共有398例患者入组，其中TTMB组185例，SB组213例。TTMB组活检针数（53.5比18.1）、活检阳性率[28.1%（52/185）比15.5%(33/213)]、csPCa率[15.7%（29/185）比8.9%(19/213)]均显著高于SB组。在根治性前列腺切除术中，与SB相比，TTMB的病理降级更高（36.4%比19.2%），病理升级更低（6.8%比30.8%）。TTMB组血尿（37.8%）、会阴血肿（34%）、尿潴留（11.9%）发生率显著高于SB组（P < 0.05）。TTMB组的重复活检率（13.2%）和csPCa检出率（2.5%）均显著低于SB组（28.1%和9.9）。全载病理检查发现病变118个，其中TTMB检出率为91.5%（108/118）。结论：TTMB提高了活检的准确性，有助于MRI阴性患者更精确地发现和评估肿瘤病变。

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

Prostate International Medicine-Urology

CiteScore

4.40

自引率

26.70%

发文量

审稿时长

35 days

期刊介绍： Prostate International (Prostate Int, PI), the official English-language journal of Asian Pacific Prostate Society (APPS), is an international peer-reviewed academic journal dedicated to basic and clinical studies on prostate cancer, benign prostatic hyperplasia, prostatitis, and ...