| Autor: |
Cata, E. D., Andras, I., Coman, R. T., Stanca, D. V., Bungardean, C., Szora, A. T., Caraiani, C., Coman, I., Crisan, N. |
| Předmět: |
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| Zdroj: |
Romanian Journal of Urology; 2018, Vol. 17 Issue 4, p22-26, 5p |
| Abstrakt: |
Introduction and Objectives. Prostate Imaging Reporting and Data System (PIRADS) was developed in order to standardize the reporting of mpMRI and to establish clear guidelines for the characterization of suspect lesions in the prostate. By assigning a score from 1 to 5, the PIRADS shows the probability of every lesion to harbor clinically significant prostate cancer (PCa). Despite clear recommendations in case of PIRADS Score 1/2 or 4/5 lesions, it does not exist a consensus regarding PIRADS 3 areas. Materials and Methods. We performed a retrospective analysis of the patients who presented to our department between January 2017 and January 2019 with the clinical or biochemical suspicion of PCa and harbored PIRADS 3 lesions. Our study included 37 patients. In all patients a 1-3 core MRI-TRUS Fusion targeted biopsy was performed along with the 12 core standard systematic biopsy. Results. The mean age of the patients was 62.9 years (±5.8 years), the mean PSA was 7.38 ng/ml (±5.19 ng/ml) and the mean prostate volume was 62.2 g (±23.2 g). Overall cancer diagnosis rate was 27%, whereas clinically significant PCa was present in 8.1% of the cases. All lesions located in the TZ were confirmed as benign. All patients with Gleason group III PCa were confirmed both on systematic and targeted biopsy. MRI-TRUS fusion biopsy showed the possibility to reduce the overdiagnosis of indolent PCa by 50%, but missed one patient with Gleason group II PCa. Conclusions. The overall and csPCa detection rate in patients with PIRADS 3 lesions is low. Performing only MRI-TRUS fusion targeted cores leads to an accurate diagnosis of aggressive PCa in these patients and can reduce the overdiagnosis of indolent disease by 50%. Further methods are needed in order to refine the indication for biopsy in patients who harbor PIRADS 3 lesions. [ABSTRACT FROM AUTHOR] |
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