Comparison of contrast-enhanced ultrasound targeted biopsy versus standard systematic biopsy for clinically significant prostate cancer detection: results of a prospective cohort study with 1024 patients
Comparison of contrast-enhanced ultrasound targeted biopsy versus standard systematic biopsy for clinically significant prostate cancer detection: results of a prospective cohort study with 1024 patients
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对比增强超声靶向活检与标准系统活检在临床意义的前列腺癌检测方面的比较：一项针对 1024 名患者的前瞻性队列研究的结果
DOI：
10.1007/s00345-018-2441-1
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发表时间：
2018-09
影响因子：
3.4
通讯作者：
Qi Jun
中科院分区：
文献类型：
--
作者：
Zhu Yunkai;Chen Yaqing;Jiang Jun;Qi Tingyue;Liu Weiyong;Qu Yuehong;Guan Wenbin;Wang Lifeng;Qi Jun
PurposeTo评估对比增强超声（CEUS）靶向活检（TB）的临床意义上的前列腺癌（PCa）检测与系统活检（SB）相比，MethodsA共1024例连续前列腺活检患者参加了这项前瞻性研究。CEUS由经验丰富的放射科医师进行，对所有临床数据均不知情。可疑病变的对比后图像进行采样，除了标准的12核心SB。临床显着的PCa检测率CEUS-TB进行了评估，在总队列和不同subgroup.ResultsIn SB的378 1024例（36.9%），PCa的诊断组织学证实。CEUS-TB检出PCa 306例（29.9%，306/1024），检出SB 317例（31.0%，317/1024），P= 0.340。在378例PCa患者中，326例（86.2%，326/378）根据Epstein标准诊断为显著PCa。CEUS-TB的PCa检出率为28.7%（294/1024），高于SB的25.3%（259/1024），P= 0.000。CEUS-TB导致67例临床显著PCa的额外病例，包括SB遗漏的51例患者和SB分级过低的16例患者。相反，SB检测到TB遗漏的32例额外显著PCa。在亚组分析中，当PSA ≤ 10.0ng/ml或前列腺体积为30 ~ 60 ml时，CEUS-TB的前列腺癌检出率显著高于SB。结论对PSA ≤ 10.0ng/ml或前列腺体积为30 ~ 60 ml的患者，通过对造影后图像异常的额外采样，可以提高有临床意义的PCa检出率。
PurposeTo assess contrast-enhanced ultrasound (CEUS) targeted biopsy (TB) for clinically significant prostate cancer (PCa) detection compared with systematic biopsy (SB).MethodsA total of 1024 consecutive patients scheduled for prostate biopsy were enrolled in this prospective study. CEUS was performed by an experienced radiologist blinded to all clinical data. Suspicious lesions on postcontrast images were sampled in addition to standard 12-core SB. The clinically significant PCa detection rate by CEUS-TB was evaluated in comparison with SB in the total cohort and in different subgroups.ResultsIn 378 of 1024 patients (36.9%), the diagnosis of PCa was histologically confirmed. PCa was detected by CEUS-TB in 306 patients (29.9%, 306/1024) and SB in 317 patients (31.0%, 317/1024,P= 0.340). Among 378 PCa patients, 326 (86.2%, 326/378) were diagnosed with significant PCa using Epstein criteria. The significant PCa detection rate of CEUS-TB was 28.7% (294/1024), which was higher than that of SB (25.3%, 259/1024,P= 0.000). CEUS-TB resulted in 67 additional cases of clinically significant PCa, including 51 patients missed by SB and 16 patients under-graded by SB. Conversely, SB detected 32 additional significant PCa missed by TB. In the subgroup analysis, CEUS-TB yielded a higher significant cancer detection rate than SB in patients with a PSA level ≤ 10.0 ng/ml or prostate volume from 30 to 60 ml.ConclusionThe clinically significant PCa detection rate could be improved by the extra sampling of abnormalities on postcontrast images, especially in patients with a PSA level ≤ 10.0 ng/ml or prostate volume from 30 to 60 ml.
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影响因子：
1.9
作者：
P. Prorok;Patrick Wright;T. Riley;B. Kramer;C. Berg;J. Gohagan
通讯作者：
P. Prorok;Patrick Wright;T. Riley;B. Kramer;C. Berg;J. Gohagan
影响因子：
23.4
作者：
Loeb, Stacy;Bjurlin, Marc A.;Nicholson, Joseph;Tammela, Teuvo L.;Penson, David F.;Carter, H. Ballentine;Carroll, Peter;Etzioni, Ruth
通讯作者：
Etzioni, Ruth
影响因子：
4.5
作者：
Eisenberg, Michael L.;Cowan, Janet E.;Shinohara, Katsuto
通讯作者：
Shinohara, Katsuto
影响因子：
5.6
作者：
Karram, Sarah;Trock, Bruce J.;Epstein, Jonathan I.
通讯作者：
Epstein, Jonathan I.
影响因子：
23.4
作者：
Siddiqui MM;Rais-Bahrami S;Truong H;Stamatakis L;Vourganti S;Nix J;Hoang AN;Walton-Diaz A;Shuch B;Weintraub M;Kruecker J;Amalou H;Turkbey B;Merino MJ;Choyke PL;Wood BJ;Pinto PA
通讯作者：
Pinto PA