Magnetic resonance/transrectal ultrasound fusion biopsy of the prostate compared to systematic 12-core biopsy for the diagnosis and characterization of prostate cancer: multi-institutional retrospective analysis of 389 patients
Magnetic resonance/transrectal ultrasound fusion biopsy of the prostate compared to systematic 12-core biopsy for the diagnosis and characterization of prostate cancer: multi-institutional retrospective analysis of 389 patients
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DOI：
10.1016/j.urolonc.2016.04.008
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发表时间：
2016-09-01
影响因子：
2.7
通讯作者：
Baroni, Ronaldo H.
中科院分区：
文献类型：
--
作者：
Mariotti, Guilherme C.;Costa, Daniel N.;Baroni, Ronaldo H.
目的：确定在 2 个学术中心使用不同的多参数磁共振成像 (MRI) 方案、一大群放射科医生、多个活检系统和不同的活检操作员进行的扩展六分仪活检方案中添加靶向活检的增量诊断价值，对每个患者进行风险分层。 材料和方法：对 2013 年 2 月至 2015 年 1 月期间在 2 个学术中心接受前列腺多参数 MRI 的所有疑似前列腺癌 (PCa) 患者进行随访通过系统和有针对性的MRI-经直肠超声融合活检进行了综述。将系统活检的风险分层检出率与针对每位患者的靶向活检进行比较。 McNemar 检验用于比较两种方法的诊断性能。结果：共有 389 名男性符合资格标准。使用靶向、系统和组合（靶向加系统）方法分别在 47% (182/389)、52%(202/389) 和 60%(235/389) 的患者中诊断出 PCa。与系统活检相比，靶向活检诊断出的中高风险肿瘤多11%（37 vs. 26）（P < 0.0001），低风险肿瘤少16%（10 vs. 16）（P < 0.0001）。当分别分析来自每个中心、未进行活检的患者和既往活检呈阴性的男性的数据时，这些结果得到了重复。结论：在临床实践中可能遇到的具有不同设备、协议、放射科医生和活检操作员的大型患者队列中，靶向 MRI-经直肠超声融合活检持续改善了临床上有意义的 PCa 的检测。 (C) 2016 Elsevier Inc. 保留所有权利。
Objective: To determine the incremental diagnostic value of targeted biopsies added to an extended sextant biopsy scheme on a per patient, risk-stratified basis in 2 academic centers using different multiparametric magnetic resonance imaging (MRI) protocols, a large group of radiologists, multiple biopsy systems, and different biopsy operators.Materials and Methods: All patients with suspected prostate cancer (PCa) who underwent multiparametric MRI of the prostate in 2 academic centers between February 2013 and January 2015 followed by systematic and targeted MRI-transrectal ultrasound fusion biopsy were reviewed. Risk-stratified detection rate using systematic biopsies was compared with targeted biopsies on a per-patient basis. The McNemar test was used to compare diagnostic performance of the 2 approaches.Results: A total of 389 men met eligibility criteria. PCa was diagnosed in 47% (182/389), 52%(202/389), and 60%(235/389) of patients using the targeted, systematic, and combined (targeted plus systematic) approach, respectively. Compared with systematic biopsy, targeted biopsy diagnosed 11% (37 vs. 26) more intermediate-to-high risk (P < 0.0001) and 16% (10 vs. 16) fewer low-risk tumors (P < 0.0001). These results were replicated when data from each center, biopsy-naive patients, and men with previous negative biopsies were analyzed separately.Conclusion: Targeted MRI-transrectal ultrasound fusion biopsy consistently improved the detection of clinically significant PCa in a large patient cohort with diverse equipment, protocols, radiologists, and biopsy operators as can be encountered in clinical practice. (C) 2016 Elsevier Inc. All rights reserved.