Lesion size may affect diagnostic capabilities of MRI-guided ultrasound fusion biopsy and cognitive targeted biopsy for clinically significant prostate cancer.

Autor: Shao IH; Division of Urology, Department of Surgery, Linkou Chang Gung Memorial Hospital, 5, Fuxing Street, Guishan District, Taoyuan City, Taiwan.; College of Medicine, Chang Gung University, Taoyuan, Taiwan.; Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan., Liao FT; Division of Urology, Department of Surgery, Linkou Chang Gung Memorial Hospital, 5, Fuxing Street, Guishan District, Taoyuan City, Taiwan., Chang CB; Department of Medical Imaging and Intervention, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan., Chang YH; College of Medicine, Chang Gung University, Taoyuan, Taiwan.; Division of Urology, Department of Surgery, New Taipei Municipal TuCheng Hospital, Chang Gung Memorial Hospital, New Taipei City, Taiwan., Wang LJ; Department of Medical Imaging and Intervention, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan., Huang LK; Division of Urology, Department of Surgery, Linkou Chang Gung Memorial Hospital, 5, Fuxing Street, Guishan District, Taoyuan City, Taiwan.; College of Medicine, Chang Gung University, Taoyuan, Taiwan., Kan HC; Division of Urology, Department of Surgery, Linkou Chang Gung Memorial Hospital, 5, Fuxing Street, Guishan District, Taoyuan City, Taiwan.; College of Medicine, Chang Gung University, Taoyuan, Taiwan., Lin PH; Division of Urology, Department of Surgery, Linkou Chang Gung Memorial Hospital, 5, Fuxing Street, Guishan District, Taoyuan City, Taiwan., Yu KJ; Division of Urology, Department of Surgery, Linkou Chang Gung Memorial Hospital, 5, Fuxing Street, Guishan District, Taoyuan City, Taiwan.; College of Medicine, Chang Gung University, Taoyuan, Taiwan., Chuang CK; Division of Urology, Department of Surgery, Linkou Chang Gung Memorial Hospital, 5, Fuxing Street, Guishan District, Taoyuan City, Taiwan.; College of Medicine, Chang Gung University, Taoyuan, Taiwan., Wu CT; Division of Urology, Department of Surgery, Linkou Chang Gung Memorial Hospital, 5, Fuxing Street, Guishan District, Taoyuan City, Taiwan.; College of Medicine, Chang Gung University, Taoyuan, Taiwan., Pang ST; Division of Urology, Department of Surgery, Linkou Chang Gung Memorial Hospital, 5, Fuxing Street, Guishan District, Taoyuan City, Taiwan. pst64lab@gmail.com.; College of Medicine, Chang Gung University, Taoyuan, Taiwan. pst64lab@gmail.com.
Jazyk: angličtina
Zdroj: Scientific reports [Sci Rep] 2024 Aug 30; Vol. 14 (1), pp. 20173. Date of Electronic Publication: 2024 Aug 30.
DOI: 10.1038/s41598-024-69661-4
Abstrakt: MRI-guided targeted biopsy (MRGB) was recommended as part of biopsy paradigm of prostate cancers by current guidelines. This study aimed to analyze the diagnostic efficacy of MRGB and systemic biopsy (SB), and to compare diagnostic capabilities within subgroups of MRGB: MRI-cognitive biopsy (MRCB) and MRI-fusion biopsy (MRFB). We retrospectively enrolled patients who underwent MRGB for suspicious malignant lesion(s) identified on MRI in a single tertiary center, sample size was 74 patients. An mpMRI was performed prior to biopsy and reviewed by an experienced radiologist specialized in prostate cancer. Per-person results of MRGB and each concomitant SB were analyzed as independent biopsies for its positive biopsy rate and positive core percentage. Per-lesion results of MRFB and MRCB were compared for the detection rate. Variables of interest were analyzed with t-test, chi-squared test, and logistic regression analysis. Statistical analyses were performed with IBM Statistical Product and Service Solutions (SPSS), Version 23 (IBM, Armonk, New York). Total of 74 patients fulfilled the inclusion criteria and were enrolled. MRFB had higher PCa detection rate comparing to both MRCB and SB (56.1%, 30.3%, and 33.9% respectively, p value = 0.036); clinically significant prostate cancer (csPCa) detection rate was also significantly higher in MRFB group (43.9%, 24.2%, and 16.9% in each group respectively, p value = 0.011). In per-lesion analysis, MRCB and MRFB had no significant difference in PCa and csPCa detection rate (41.0% vs. 26.2% and 29.5% vs. 16.7% respectively, p value = 0.090 and 0.103). In the lesion ≦ 1.3 cm group, MRFB could achieve higher PCa detection rate, comparing to MRCB (36.4% vs. 14.3%, p value = 0.047); there were also higher positive rates for PCa and csPCa per biopsied cores (22.1% vs. 6.8% and 15.6% vs. 2.7%, p value = 0.029 and 0.028, respectively). Further logistic regression of multi-variate analysis in subgroup of lesion ≦ 1.3 cm revealed that PIRADS score and biopsy method were significant predictors of positive biopsy result for PCa (p value = 0.045 and 0.026, respectively) and for csPCa (p value = 0.043 and 0.025, respectively). In patients receiving trans-perineal prostate biopsy, MRFB had higher cancer detection rate than MRCB and SB. In per lesion comparison, MRFB and MRCB had similar diagnostic accuracy. However, in lesions with diameter less than 1.3 cm, MRFB can provided better diagnose value for PCa and csPCa than MRCB.
(© 2024. The Author(s).)
Databáze: MEDLINE
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