Direct Comparison of Targeted MRI-Guided Biopsy with Systematic Transrectal Ultrasound-Guided Biopsy in Patients with Previous Negative Prostate Biopsies
Direct Comparison of Targeted MRI-Guided Biopsy with Systematic Transrectal Ultrasound-Guided Biopsy in Patients with Previous Negative Prostate Biopsies
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DOI：
10.1159/000365397
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发表时间：
2015-01-01
影响因子：
1.6
通讯作者：
Schilling, David
中科院分区：
文献类型：
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作者：
Kaufmann, Sascha;Kruck, Stephan;Schilling, David
目的：直接比较mri定向活检（MR-GB）和系统经直肠超声引导活检（truss - gb）的诊断性能。方法：采用前列腺影像学报告与数据系统（PI-RADS）评分，纳入35例在多参数MRI （mpMRI）上至少有1项TRUS-GB阴性、前列腺特异性抗原持续升高或升高、疑似前列腺癌（PC）病变的患者。每个病变中位数为三次靶向活检，随后由独立的泌尿科医生在不知道MRI结果的情况下进行系统的TRUS-GB检查。对明确的病理报告进行解剖定位和临床意义标准分析。结果：MR-GB的肿瘤检出率明显高于TRUS-GB（分别为16/35、46%和8/35、23%，p < 0.05）。所有TRUS-GB阳性患者MR-GB均检出PC。MR-GB检测到的所有肿瘤至少有一项具有临床意义的标准。PC病变PI-RADS总评分明显高于良性病变。结论：与TRUS-GB相比，MR-GB能更有效地检测出TRUS-GB阴性的男性有临床意义的PC。PI-RADS评分提供了额外的信息，可以作为考虑再次活检的决策过程的一部分。在接受靶向MR-GB的患者中，可以省去额外的系统活检。(C) 2014 S. Karger AG，巴塞尔
Objective: To directly compare the diagnostic performance of targeted MRI-guided biopsy (MR-GB) and systematic transrectal ultrasound-guided biopsy (TRUS-GB). Methods: Thirty-five patients with at least one negative TRUS-GB, persistently elevated or rising prostate-specific antigen and a lesion suspicious for prostate cancer (PC) on multiparametric MRI (mpMRI) scored by using the Prostate Imaging Reporting and Data System (PI-RADS) were included. A median of three targeted biopsies per lesion were obtained and systematic TRUS-GB was performed subsequently by an independent urologist without knowledge of the MRI findings. Definite pathology reports were analyzed for anatomical location and criteria of clinical significance. Results: The tumor detection rate was significantly higher with MR-GB compared with TRUS-GB (16/35, 46% and 8/35, 23%, respectively, p < 0.05). MR-GB detected PC in all patients with positive TRUS-GB. All tumors detected by MR-GB exhibited at least one criterion of clinical significance. PC lesions showed a significantly higher PI-RADS sum score compared with benign lesions. Conclusions: MR-GB is more effective compared with TRUS-GB in detecting clinically significant PC in men after previous negative TRUS-GB. PI-RADS scores give additional information and could be part of the decision-making process when considering retrial biopsy. Additional systematic biopsy can be omitted in patients undergoing targeted MR-GB. (C) 2014 S. Karger AG, Basel