Detection of anterior prostate cancer using a magnetic resonance imaging-transrectal ultrasound fusion biopsy in cases with initial biopsy and history of systematic biopsies

IF 2.7 2区医学 Q2 UROLOGY & NEPHROLOGY

Prostate International Pub Date : 2023-12-01 DOI:10.1016/j.prnil.2023.08.002

Masakazu Abe , Ryo Takata , Daiki Ikarashi , Kie Sekiguchi , Daichi Tamura , Shigekatsu Maekawa , Renpei Kato , Mitsugu Kanehira , Takashi Ujiie , Wataru Obara

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引用次数: 0

Abstract

Background

Prostate cancer in the anterior region may be missed on a transrectal systematic biopsy (SBx). Therefore, this study aimed to evaluate the performance of magnetic resonance imaging-transrectal ultrasound (MRI-TRUS) fusion targeted biopsy (TBx) in detecting anterior region cancer in patients with a history of SBxs.

Methods

Prostate biopsies were performed in 224 patients after multiparametric MRI, among whom 119 patients with prostate imaging reporting and data system (PI-RADS version 2) scores of 3 to 5 underwent MRI-TRUS fusion TBxs. Afterward, cancer detection rates (CDRs) and TBx-positive core regions were compared by categorizing patients into those with or without a history of SBxs.

Results

Total CDR was 68.8% (44/64 cases) in the initial biopsy group (Initial-Bx group) and 47.3% (26/55 cases) in the previous-negative-systematic biopsy group (Pre-Neg-SBx group) (P = 0.018). Interestingly, both TBx- and SBx-core positive cases were more common in the Initial-Bx group than in the Pre-Neg-SBx group (Initial-Bx group: 75% [33/44 cases] vs. Pre-Neg-SBx group: 42.3% [11/26 cases], P = 0.006). However, only TBx-core positive cases were more common in the Pre-Neg-SBx group than in the Initial-Bx group (Initial-Bx group: 11.4% [5/44 cases] vs. Pre-Neg-SBx group: 30.8% [8/26 cases], P = 0.043). In addition, the proportion of anterior lesions detected by TBx cores was higher in the Pre-Neg-SBx group than in the Initial-Bx group (Initial-Bx group: 26.3% [10/38 cases] vs. Pre-Neg-SBx group: 52.6% [10/19 cases], P = 0.049).

Conclusion

Using MRI-TRUS fusion TBx in the evaluation of previously negative SBx cases improved the detection rate of anterior lesions, which might have been missed in previous SBxs. Especially in patients with a history of SBxs mpMRI should be performed to screen for anterior lesions.

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磁共振成像经直肠超声融合活组织检查有系统活组织检查病史的前前列腺癌症

背景经直肠系统性活检（SBx）可能会漏检前区的前列腺癌。因此，本研究旨在评估磁共振成像-经直肠超声（MRI-TRUS）融合靶向活检（TBx）在检测有 SBx 病史的患者前区癌症方面的性能。方法对 224 名患者进行多参数磁共振成像后进行前列腺活检，其中 119 名前列腺成像报告和数据系统（PI-RADS 2 版）评分为 3 到 5 分的患者接受了磁共振成像-TRUS 融合 TBx。结果初次活检组（Initial-Bx 组）的总 CDR 为 68.8%（44/64 例），先前阴性系统活检组（Pre-Neg-SBx 组）的 CDR 为 47.3%（26/55 例）（P = 0.018）。有趣的是，TBx 和 SBx 核心阳性病例在 Initial-Bx 组比在阴性前-SBx 组更常见（Initial-Bx 组：75% [33/44 例] vs SBx-核心阳性病例）：75%[33/44例] vs. 阴性前-SBx组：42.3%[11/26例]，P = 0.006）。然而，只有 TBx 核心阳性病例在阴性前-SBx 组比初始-Bx 组更常见（初始-Bx 组：11.4% [5/44 例]；阴性前-SBx 组：42.3% [11/26 例]）：11.4%[5/44例] vs. 阴性前-SBx组：30.8% [8/26 例]，P = 0.043）。此外，通过 TBx 核芯检测到前部病变的比例，阴性前-Bx 组高于初始-Bx 组（初始-Bx 组：26.3% [10/38 例] vs. 阴性前-Bx 组：52.6% [10/19 例]）：结论在评估既往SBx阴性病例时使用MRI-TRUS融合TBx可提高既往SBx可能漏诊的前部病变的检出率。特别是对有 SBx 病史的患者，应进行 mpMRI 检查以筛查前部病变。

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 ...