MRI-ultrasound fusion for guidance of targeted prostate biopsy.
MRI-ultrasound fusion for guidance of targeted prostate biopsy.
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DOI：
10.1097/mou.0b013e32835ad3ee
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发表时间：
2013-01
影响因子：
2.5
通讯作者：
Natarajan S
中科院分区：
文献类型：
--
作者：
Marks L;Young S;Natarajan S
前列腺癌（CaP）可以在MRI上检测到。MRI与超声的融合使泌尿科医生能够从盲目的、系统的活检进展到活检，活检是映射的、有针对性的和跟踪的。我们在此回顾了通过MRI/超声融合进行前列腺活检的现状。最近已经描述了三种融合MRI用于靶向活检的方法：MRI超声融合、MRI-MRI融合（“孔内”活检）和认知融合。融合器的支持性数据正在出现，其中两种在过去5年内获得了美国食品药品监督管理局的批准：Artemis（Eigen，美国）和Urostation（Koelis，法国）。在600多名患者中使用Artemis设备，我们发现靶向活检检测CaP的灵敏度是非靶向系统活检的两到三倍;近40%的Gleason评分至少为7 CaP的男性仅通过靶向活检诊断;近100%的高度可疑MRI病变的男性被诊断为CaP;返回到先前活检部位的能力是高度准确的（在1.2 ± 1.1 mm内）;在预测整个器官疾病方面，靶向和系统性活检的准确性是单独系统性活检的两倍。在未来，MRI-超声融合病变定位可能会导致更少和更准确的前列腺活检比目前使用的系统活检与超声引导单独。
Prostate cancer (CaP) may be detected on MRI. Fusion of MRI with ultrasound allows urologists to progress from blind, systematic biopsies to biopsies, which are mapped, targeted and tracked. We herein review the current status of prostate biopsy via MRI/ultrasound fusion. Three methods of fusing MRI for targeted biopsy have been recently described: MRI–ultrasound fusion, MRI–MRI fusion (‘in-bore’ biopsy) and cognitive fusion. Supportive data are emerging for the fusion devices, two of which received US Food and Drug Administration approval in the past 5 years: Artemis (Eigen, USA) and Urostation (Koelis, France). Working with the Artemis device in more than 600 individuals, we found that targeted biopsies are two to three times more sensitive for detection of CaP than nontargeted systematic biopsies; nearly 40% of men with Gleason score of at least 7 CaP are diagnosed only by targeted biopsy; nearly 100% of men with highly suspicious MRI lesions are diagnosed with CaP; ability to return to a prior biopsy site is highly accurate (within 1.2 ± 1.1 mm); and targeted and systematic biopsies are twice as accurate as systematic biopsies alone in predicting whole-organ disease. In the future, MRI–ultrasound fusion for lesion targeting is likely to result in fewer and more accurate prostate biopsies than the present use of systematic biopsies with ultrasound guidance alone.