期刊
EUROPEAN RADIOLOGY
卷 28, 期 1, 页码 11-16出版社
SPRINGER
DOI: 10.1007/s00330-017-4939-0
关键词
Magnetic Resonance Imaging/methods; Prospective Studies; Prostatic Neoplasms/diagnosis; Ultrasonography; Interventional; Needle biopsy
To compare the incremental diagnostic value of targeted biopsy using real-time multiparametric magnetic resonance imaging and transrectal ultrasound (mpMRI-TRUS) fusion to conventional 14-cores biopsy. Uni-institutional, institutional review board (IRB) approved prospective blinded study comparing TRUS-guided random and targeted biopsy using mpMRI-TRUS fusion, in 100 consecutive men. We included men with clinical-laboratorial suspicious for prostate cancer and Likert score ae 3 mp-MRI. Patients previously diagnosed with prostate cancer were excluded. All patients were submitted to 14-cores TRUS-guided biopsy (mpMRI data operator-blinded), followed by targeted biopsy using mpMRI-TRUS fusion. There was an overall increase in cancer detection rate, from 56% with random technique to 62% combining targeted biopsy using mpMRI-TRUS fusion; incremental diagnosis was even more relevant for clinically significant lesions (Gleason ae 7), diagnosing 10% more clinically significant lesions with fusion biopsy technique. Diagnosis upgrade occurred in 5 patients that would have negative results in random biopsies and had clinically significant tumours with the combined technique, and in 5 patients who had the diagnosis of significant tumours after fusion biopsy and clinically insignificant tumours in random biopsies(p=0.0010). Targeted biopsy using mpMRI-TRUS fusion has incremental diagnostic value in comparison to conventional random biopsy, better detecting clinically significant prostate cancers. aEuro cent mpMRI-TRUS targeted biopsy increases overall cancer detection rate, but not statistically significant. aEuro cent mpMRI-TRUS targeted biopsy actually improves the diagnosis of clinically significant PCa. aEuro cent There was no evidence to acquire the mpMRI-TRUS fusion cores alone.
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