Evaluating the diagnostic role of in-bore magnetic resonance imaging guided prostate biopsy: a single-centre study.

Autor: Furrer MA; Department of Urology, Royal Melbourne Hospital, Melbourne, Victoria, Australia.; Department of Urology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland., Hong A; Department of Urology, Royal Melbourne Hospital, Melbourne, Victoria, Australia., Wetherell D; Department of Urology, Royal Melbourne Hospital, Melbourne, Victoria, Australia., Heinze SB; Department of Radiology, Royal Melbourne Hospital, Melbourne, Victoria, Australia., Simkin P; Department of Radiology, Royal Melbourne Hospital, Melbourne, Victoria, Australia., Chow K; Department of Urology, Royal Melbourne Hospital, Melbourne, Victoria, Australia.; Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia.; Department of Urology, Western Health, Melbourne, Victoria, Australia., Lawrentschuk N; Department of Urology, Royal Melbourne Hospital, Melbourne, Victoria, Australia.; Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia., Zargar H; Department of Urology, Royal Melbourne Hospital, Melbourne, Victoria, Australia.; Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia.
Jazyk: angličtina
Zdroj: ANZ journal of surgery [ANZ J Surg] 2022 Jun; Vol. 92 (6), pp. 1486-1491. Date of Electronic Publication: 2022 Apr 28.
DOI: 10.1111/ans.17713
Abstrakt: Background: To evaluate the role of in-bore MRI-guided biopsy (IB-MRGB) in the diagnosis of clinically significant prostate cancer (csPCa).
Methods: In this tertiary single centre study, a total of 125 consecutive patients receiving IB-MRGB over a three-year period were evaluated, including 73 patients who had prior biopsies and 52 biopsy-naïve patients. We assessed cancer detection rate of patients according to the degree of suspicion based on mpMRI findings. Histopathological data were reviewed by experienced uropathologists.
Results: The mpMRI was suspicious for PCa (PI-RADS 4/5) in 77% (96/125) and equivocal (PI-RADS 3) in 23% (29/125). The detection rate for csPCa was 54.2% (52/96) and 20.7% (6/29) for suspicious lesions (PI-RADS 4/5) and equivocal lesions (PI-RADS 3), respectively. In subgroup analysis, patients with previous negative biopsy, overall positive biopsy rate and csPCa detection rate were 48.3% (19/35) and 34.5% (13/35), respectively. In patients on AS, 36/44 (81.8%) and 21/44 (47.8%) had PCa and csPCa respectively. In biopsy-naïve patients 34/52 (65.4%) and 27/52 (51.92%) had PCa and csPCa respectively. Of the patients on AS, 18/44 (41.6%) upgraded from ISUP 1 to ISUP 2 PCa, and 4/44 (9.1%) upgraded from ISUP 1 to ISUP 3 PCa on IB-MRGB. A total of 14 Clavien-Dindo≤2 complications occurred in 14 patients (11.2%) that were directly related to the biopsy. No Clavien-Dindo≥3 complications occurred.
Conclusion: MRI-targeted biopsy is suitable for assessment of csPCa. Given the favourable complications profile, its use may be considered in both the initial biopsy and re-biopsy settings.
(© 2022 The Authors. ANZ Journal of Surgery published by John Wiley & Sons Australia, Ltd on behalf of Royal Australasian College of Surgeons.)
Databáze: MEDLINE
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