Targeted MRI-guided Prostate Biopsies for the Detection of Prostate Cancer: Initial Clinical Experience With Real-time 3-Dimensional Transrectal Ultrasound Guidance and Magnetic Resonance/Transrectal Ultrasound Image Fusion
Targeted MRI-guided Prostate Biopsies for the Detection of Prostate Cancer: Initial Clinical Experience With Real-time 3-Dimensional Transrectal Ultrasound Guidance and Magnetic Resonance/Transrectal Ultrasound Image Fusion
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DOI：
10.1016/j.urology.2013.02.022
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发表时间：
2013-06-01
期刊：
影响因子：
2.1
通讯作者：
Long, Jean-Alexandre
中科院分区：
文献类型：
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作者：
Fiard, Gaelle;Hohn, Noelie;Long, Jean-Alexandre
目的通过磁共振成像(MRI)/经直肠超声（TRUS）登记，验证Urostation新型平台靶向前列腺活检的可行性，并评估其初步临床结果，以帮助引导活检针指向可疑部位。方法前瞻性纳入2011年11月至2012年8月30例疑似前列腺癌患者。所有患者之前都通过多参数MRI进行评估，由一名放射科医生对每个病变进行前列腺成像报告和数据系统（PI-RADS）评分。进行常规的12芯随机活检方案，并在可疑区域进行2次额外的靶向活检。比较随机活检和靶向活检的结果。结果30例患者中，MRI上发现可疑病灶20例（67%）。中位手术时间为23分钟。靶向成功率（活检在靶内可见）为83%，所有病例中至少有1例活检达到靶。前列腺癌14例（47%），其中MRI异常11例。11例患者均经靶向活检检出肿瘤，除1例外其余均有临床意义。随机活检发现了这11例中的10例，另外3例MRI认为正常。两种方法检测重要癌症的灵敏度均为91%。结论：这项初步的临床研究显示了使用MRI-TRUS融合进行靶向mri引导前列腺活检的令人鼓舞的结果。虽然需要进一步的研究来确定前列腺活检前MRI的作用和靶向活检的相关性，但Urostation是一种MRI- trus融合装置，在MRI上靶向可疑区域具有良好的准确性。(C) 2013爱思唯尔公司
OBJECTIVE To prove the feasibility and evaluate the initial clinical results of targeted prostate biopsies using the Urostation novel platform using magnetic resonance imaging (MRI)/transrectal ultrasound (TRUS) registration to help steer the biopsy needle to suspicious areas.METHODS We prospectively included 30 patients for suspicion of prostate cancer from November 2011 to August 2012. All patients were previously evaluated by a multiparametric MRI, interpreted by a single radiologist who attributed a Prostate Imaging-Reporting and Data System (PI-RADS) score to each lesion. A conventional 12-core randomized biopsy protocol was performed and 2 additional targeted biopsies were performed on suspicious area(s). The results of randomized and targeted biopsies were compared.RESULTS Among the 30 patients, suspicious area(s) were found on MRI in 20 cases (67%). Median procedure time was 23 minutes. Targeting success rate (biopsy visualized inside the target) was 83%, with at least 1 biopsy reaching the target in all cases. Prostate cancer was detected in 14 cases (47%), including 11 cases with an abnormal MRI. Targeted biopsies detected cancer in all 11 cases and all but 1 were clinically significant. Randomized biopsies detected 10 of these 11 cases, and 3 more cases that MRI considered normal. Sensitivity to detect a significant cancer was 91% in both modalities.CONCLUSION This initial clinical study showed encouraging results for targeted MRI-guided prostate biopsies using MRI-TRUS fusion. Although further studies are needed to determine the role of prostate MRI before biopsy and the relevance of targeted biopsies, the Urostation is an MRI-TRUS fusion device that has good accuracy for targeting suspicious areas on MRI. (C) 2013 Elsevier Inc.