Multiparametric magnetic resonance imaging and ultrasound fusion biopsy detect prostate cancer in patients with prior negative transrectal ultrasound biopsies.

Multiparametric magnetic resonance imaging and ultrasound fusion biopsy detect prostate cancer in patients with prior negative transrectal ultrasound biopsies.
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DOI:
10.1016/j.juro.2012.08.025
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发表时间:
2012-12
期刊:
影响因子:
6.6
通讯作者:
Pinto, Peter A.
Pinto, Peter A.
中科院分区:
医学1区
文献类型:
--
作者:
Vourganti, Srinivas;Rastinehad, Ardeshir;Yerram, Nitin K.;Nix, Jeffrey;Volkin, Dmitry;Hoang, An;Turkbey, Baris;Gupta, Gopal N.;Kruecker, Jochen;Linehan, W. Marston;Choyke, Peter L.;Wood, Bradford J.;Pinto, Peter A.

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TRUS活检阴性但PSA值持续升高的患者有发生隐匿性但显著的前列腺癌的风险。多参数MRI和超声(MRI/US)融合活检检测这些隐匿性前列腺病变的能力可能使其成为这种具有挑战性的情况下的有效工具。有一个或多个阴性系统前列腺活检的男性参加了这项试验。2007年3月至2011年11月期间,所有男性均接受了前列腺3 T直肠内线圈MRI和MRI/US融合活检。此外,所有患者均接受了标准12芯TRUS活检以及MRI上识别的相关病变的靶向MRI/US融合活检。在195名既往活检阴性的男性中,使用MRI/US融合平台结合12个核心TRUS活检发现73名(37%)患有癌症。在21名男性(11%)中发现了高级别癌症(Gleason sum 8+)。MRI/US融合靶向活检检测到所有21例高级别疾病(100%),而标准TRUS活检遗漏了12例高级别癌症(55%)。28名男性(38.9%)因MRI靶向与标准TRUS活检相比而发生升级。MRI引导活检的诊断率与既往阴性活检的数量无关,尽管既往活检次数增加,但诊断率仍持续存在。在多变量分析中,只有PSAD和MRI怀疑水平仍然是癌症的重要预测因子。多参数MRI结合MRI/US融合活检平台是检测前列腺癌的一种新型诊断工具,可能非常适合临床上持续怀疑癌症的TRUS活检阴性患者。
Patients with negative TRUS biopsies yet persistently rising PSA values are at risk for occult but significant prostate cancers. The ability of multiparametric MRI and ultrasound (MRI/US) fusion biopsy to detect these occult prostate lesions may make it an effective tool in this challenging scenario. Men with one or more negative systematic prostate biopsies participated in this trial. Between March 2007 and November 2011 all men underwent prostate 3T endorectal coil MRI and MRI/US fusion biopsy. In addition, all patients underwent standard 12 core TRUS biopsy in addition to targeted MRI/US fusion biopsy of concerning lesions identified on MRI. Of the 195 men with previous negative biopsies, 73 (37%) were found to have cancer using the MRI/US fusion platform combined with 12 core TRUS biopsy. High grade cancer (Gleason sum 8+) was discovered in 21 men (11%). All 21 men with high grade disease (100%) were detected with MRI/US fusion targeted biopsy while standard TRUS biopsy missed 12 of these high grade cancers (55%). Upgrading occurred in 28 men (38.9%) as a result of MRI targeting versus standard TRUS biopsy. The diagnostic yield of MRI with guided biopsy was unrelated to the number of previous negative biopsies, and persisted despite increasing number of previous biopsy sessions. On multivariable analysis, only PSAD and MRI suspicion level remained significant predictors of cancer. Multiparametric MRI in conjunction with a MRI/US fusion biopsy platform is a novel diagnostic tool for detecting prostate cancer and may be ideally suited for patients with negative TRUS biopsies in the face of a persistent clinical suspicion for cancer.
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发表时间: 2011-09-01
期刊: JOURNAL OF UROLOGY
影响因子: 6.6
作者:
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发表时间: 2002-06-01
期刊: JOURNAL OF UROLOGY
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DOI: 10.1016/j.juro.2011.07.013
发表时间: 2011-11
期刊: The Journal of urology
影响因子: --
作者:
Turkbey B;Mani H;Shah V;Rastinehad AR;Bernardo M;Pohida T;Pang Y;Daar D;Benjamin C;McKinney YL;Trivedi H;Chua C;Bratslavsky G;Shih JH;Linehan WM;Merino MJ;Choyke PL;Pinto PA
通讯作者: Pinto PA
DOI: 10.1016/j.urolonc.2008.10.029
发表时间: 2009-05-01
影响因子: 2.7
作者:
Presti, Joseph C., Jr.
通讯作者: Presti, Joseph C., Jr.