期刊
BJU INTERNATIONAL
卷 125, 期 2, 页码 260-269出版社
WILEY
DOI: 10.1111/bju.14865
关键词
transperineal; magnetic resonance imaging; MRI-TRUS fusion; prostate biopsy; #ProstateCancer; #PCSM
资金
- RWTH Aachen University Hospital (Aachen, Germany)
- Philips Healthcare Germany clinical research fellowship (Hamburg, Germany)
- Cancer Research UK
- National Institute of Health Research (NIHR) Cambridge Biomedical Research Centre (BRC)
- Engineering and Physical Sciences Research Council Imaging Centre in Cambridge and Manchester
- Cambridge Experimental Cancer Medicine Centre
- NIHR Cambridge BRC, UK
Objectives To assess cancer detection rates of different target-dependent transperineal magnetic resonance (MR)/ultrasonography (US) fusion-guided biopsy templates with reduced number of systematic cores. Patients and Methods Single-centre outcome of transperineal MR/US fusion-guided biopsies of 487 men with a single target MR imaging (MRI) lesion, prospectively collected between 2012 and 2016. All men underwent transperineal targeted biopsy (TB) with two cores, followed by 18-24 systematic sector biopsies (SB) using the Ginsburg protocol. Gleason score >= 7 prostate cancer detection rates for two-core TB, four-core extended TB (eTB), 10- to 20-core saturation TB (sTB) including cores from sectors adjacent to the target, and 14 core ipsilateral TB (iTB) were compared to combined TB+SB. Results Cancer was detected in 345 men and Gleason score 7-10 cancer in 211 men. TB alone detected 67%, eTB 76%, sTB 91% and iTB 91% of these Gleason score 7-10 cancers. In the subgroup of 33 men (7% of cohort) with an anterior >0.5 mL highly suspicious MRI lesion and a prostate volume <= 45 mL, four-core eTB detected 31 of 32 cancers (97%) and all 26 Gleason score 7-10 cancers. Conclusion sTB detected Gleason score 7-10 cancer in 25% more of the men than a two-core TB approach, and in almost as many men (91%) as the 20-26-core combined TB+SB, while needing only 10-20 cores. A four-core extended TB may suffice for large, highly suspicious anterior lesions in small or slightly enlarged prostates.
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