Magnetic Resonance Imaging (MRI)-Targeted Biopsy in Patients with Prostate-Specific Antigen (PSA) Levels <20 ng/mL: A Single-Center Study in Northeastern China.
Magnetic Resonance Imaging (MRI)-Targeted Biopsy in Patients with Prostate-Specific Antigen (PSA) Levels <20 ng/mL: A Single-Center Study in Northeastern China.
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对前列腺特异性抗原 (PSA) 水平患者进行磁共振成像 (MRI) 靶向活检
DOI：
10.12659/msm.930234
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发表时间：
2021-08-08
期刊：
影响因子：
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通讯作者：
Liu Z
中科院分区：
文献类型：
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作者：
Dai Z;Liu Y;Huangfu Z;Wang L;Liu Z
我们研究了在前列腺特异性抗原(PSA)水平<20 ng/mL的患者中应用磁共振成像(MRI)靶向活检(TB)的可行性。我们根据前列腺成像记录和数据系统2.0版(PI-RADS v2)对218例PSA水平<20 ng/mL和可疑病变的患者进行了回顾性分析。所有218名男性均接受了经会阴MRI-TB检查，随后进行了模板引导的12核系统活检(SB)。在218名接受结核病治疗的患者中，100名接受了MRI-超声辅助的软件融合活检(FB)，118名接受了认知活检(CB)。临床意义前列腺癌(CsPCA)定义为Gleason评分≥3+4。TB总阳性率与SB相似(P=0.156)，但csPCA的诊断率高于SB(P=0.034)。SB误诊csPCA占11.47%，TB误诊csPCA占5.50%。SB+TB发现的Gleason评分为7的肿瘤比单独SB发现的肿瘤更多(43比22)。CsPCA在CB和FB中的检出率相似(P=0.217)。总共有47名男性有两个核磁共振确定的可疑区域。在265个可疑区域中，PI-RADS v2评分为3分的143个(53.96%)，4分的92个(34.71%)，5分的30个(11.32%)。PI-RADS v2评分为3分、4分和5分的患者csPCA阳性检出率分别为11.19%、48.91%和80.00%。TB提高了活检阳性率，但漏诊了部分csPCA病例。对于PSA<20 ng/mL的患者，TB联合SB可能是最合适的活检方法。
We investigated the feasibility of applying magnetic resonance imaging (MRI)-targeted biopsy (TB) in patients with prostate-specific antigen (PSA) levels <20 ng/mL. We retrospectively analyzed 218 patients with PSA levels <20 ng/mL and suspicious lesions according to the Prostate Imaging Recording and Data System version 2.0 (PI-RADS v2). All 218 men underwent transperineal MRI-TB, followed by template-guided 12-core systematic biopsy (SB). Of the 218 patients undergoing TB, 100 received MRI-ultrasound-assisted software fusion biopsy (FB) and 118 received cognitive biopsy (CB). Clinically significant prostate cancer (csPCa) was defined as a Gleason score ≥3+4. The overall TB positive rate was similar to that of SB (P=0.156), but with a higher diagnostic rate for csPCa (P=0.034). SB misdiagnosed csPCa in 11.47% of cases; TB misdiagnosed csPCa in 5.50% of cases. SB+TB detected more tumors with a Gleason score of 7 than did SB alone (43 vs 22). Detection rates of csPCa were similar for CB and FB (P=0.217). In total, 47 men had 2 MRI-determined suspicious areas. Of 265 suspicious areas, 143 (53.96%) had a PI-RADS v2 score of 3; 92 (34.71%) had a score of 4; and 30 (11.32%) had a score of 5. The positive detection rates for csPCa in patients with PI-RADS v2 scores of 3, 4, and 5, were 11.19%, 48.91%, and 80.00%, respectively. TB increased the positive biopsy detection rate but missed some cases of csPCa. TB combined with SB may be the most suitable biopsy for patients with PSA <20 ng/mL.