MRI-guided biopsy of the prostate: correlation between the cancer detection rate and the number of previous negative TRUS biopsies
MRI-guided biopsy of the prostate: correlation between the cancer detection rate and the number of previous negative TRUS biopsies
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DOI：
10.5152/dir.2013.13055
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发表时间：
2013-09-01
影响因子：
2.1
通讯作者：
Franiel, Tobias
中科院分区：
文献类型：
--
作者：
Durmus, Tahir;Reichelt, Uta;Franiel, Tobias
我们的目的是调查磁共振成像（MRI）引导下穿刺活检的前列腺癌检出率，并阐明与先前经直肠超声（TRUS）引导下穿刺活检阴性次数的可能关系。（平均年龄：65.0岁;平均前列腺特异性抗原，13.3 ng/mL），至少有一次阴性TRUS引导活检和持续怀疑前列腺癌。所有患者在1.5特斯拉下进行诊断性多参数MRI检查后接受MRI引导活检。标本立即固定，随后由经验丰富的泌尿病理学家进行评价。计算前列腺癌检出率。前列腺癌阳性和阴性核心进行了比较。对既往活检次数与前列腺癌的相关性进行了评估，1次（n=24）、2次（n=25）、3次（n=18）和4次或4次以上（n=20）TRUS引导活检阴性的患者的前列腺癌检出率分别为29.2%、40.0%、66.7%和35.0%（P = 0.087）。每例患者取出的芯的中位数量为3（范围，1-8），在患有和不患有癌症的患者之间没有显著差异（P = 0.48）。根据D 'Amico临床风险评分，36例癌症患者中有30例处于中度或高度风险。15例高危癌中有11例位于移行区（P = 0.002）。CONCLUSIONSSThis study demonstrates high cancer detection rates of MRI-guided biopsy independently of number of previous TRUS-guided biopsy and the number of taken prostate core.因此，MRI引导下活检对于怀疑前列腺癌和既往TRUS引导下活检阴性的患者来说是一种侵入性较小且有效的诊断工具。
PURPOSEWe aimed to investigate prostate cancer detection rate of magnetic resonance imaging (MRI)-guided biopsy and to elucidate possible relations to the number of prior negative transrectal ultrasonography (TRUS)-guided biopsies.MATERIALS AND METHODSEighty-seven consecutive patients (mean age, 65.0 years; mean prostate-specific antigen, 13.3 ng/mL) with at least one prior negative TRUS-guided biopsy and persistent suspicion of prostate cancer were included in this study. All patients underwent MRI-guided biopsy after a diagnostic multiparametric MRI examination at 1.5 Tesla. Specimens were immediately fixated and subsequently evaluated by an experienced uropathologist. Prostate cancer detection rates were calculated. Prostate cancer-positive and -negative cores were compared. Correlation between number of prior biopsies and presence of prostate cancer was evaluated.RESULTSCancer detection rates for patients with one (n=24), two (n=25), three (n=18), and four or more (n=20) negative TRUS-guided biopsies were 29.2%, 40.0%, 66.7%, and 35.0%, respectively (P = 0.087). The median number of removed cores per patient was 3 (range, 1-8) without a significant difference between patients with and without cancer (P = 0.48). Thirty of 36 cancer patients were at intermediate or high risk according to the D'Amico clinical risk score. Eleven of 15 high risk cancers were localized in the transition zone (P = 0.002).CONCLUSIONSThis study demonstrates high cancer detection rates of MRI-guided biopsy independent of the number of previous TRUS-guided biopsies and the number of taken prostate cores. MRI-guided biopsy therefore represents a less invasive and effective diagnostic tool for patients with prostate cancer suspicion and previous negative TRUS-guided biopsies.