MRI Fusion-Targeted Transrectal Prostate Biopsy and the Role of Prostate-Specific Antigen Density and Prostate Health Index for the Detection of Clinically Significant Prostate Cancer in Southeast Asian Men
| Autor: | Arianto Yuwono, Kian Tai Chong, Chau Hung Lee, Yuyi Yeow, Teck Wei Tan, Yee Mun Lee, Cher Heng Tan, Yung Khan Tan, Keng Siang Png |
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| Rok vydání: | 2017 |
| Předmět: |
Image-Guided Biopsy
Male medicine.medical_specialty Urology 030232 urology & nephrology Southeast asian Sensitivity and Specificity 03 medical and health sciences Health index Prostate cancer 0302 clinical medicine Asian People Predictive Value of Tests Prostate Biopsy medicine Humans Prospective Studies Aged Gynecology Singapore medicine.diagnostic_test business.industry Prostatic Neoplasms Cancer Prostate-Specific Antigen medicine.disease Magnetic Resonance Imaging PI-RADS Prostate-specific antigen medicine.anatomical_structure 030220 oncology & carcinogenesis Radiology Neoplasm Grading business |
| Zdroj: | Journal of Endourology. 31:1111-1116 |
| ISSN: | 1557-900X 0892-7790 |
| Popis: | To test the hypothesis that targeted biopsy has a higher detection rate for clinically significant prostate cancer (csPCa) than systematic biopsy. We defined csPCa as any Gleason sum ≥7 cancer. In patients with Prostate Imaging Reporting and Data System (PI-RADS) 3 lesions, to determine if factors, such as prostate-specific antigen density (PSAD) and prostate health index (PHI), can predict csPCa and help select patients for biopsy.We report the first series of targeted biopsies in Southeast Asian men, with comparison against systematic biopsy. Consecutive patients were registered into a prospective institutional review board-approved database in our institution. We reviewed patients who underwent biopsy from May 2016 to June 2017. Inclusion criteria for our study were patients with at least one PI-RADS ≥3, and who underwent both targeted and systematic biopsies in the same sitting.There were 115 patients in the study, of whom 74 (64.3%) had a previous negative systematic biopsy. Targeted biopsies detected significantly less Gleason 6 cancers than systematic biopsies (p 0.01), and demonstrated significantly higher sensitivity, specificity, positive predictive value, and negative predictive value (NPV) for the detection of csPCa. For patients with PI-RADS 3 lesions, PHI and PSAD were found to be the best predictors for csPCa. PSAD0.10 ng/mL/mL had an NPV of 93% and sensitivity of 92%, while allowing 20% of patients to avoid biopsy. PHI cutoff of27 would allow 34% of patients to avoid biopsy, with both sensitivity and NPV of 100%.Targeted prostate biopsies were found to be significantly superior to systematic biopsies for the detection of csPCa, while detecting less Gleason 6 cancer. Usage of PSAD and PHI cutoff levels in patients with PI-RADS 3 lesions may enable a number of patients to avoid unnecessary biopsy. |
| Databáze: | OpenAIRE |
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