Abstract

Purpose

Multiparametric magnetic resonance imaging (mpMRI)-ultrasound (US) fusion prostate biopsy (FBx) has demonstrated increased accuracy for prostate cancer detection at designated centers of excellence. There is a concern if their results can be reproduced in smaller centers. Here, we evaluate the outcomes of FBx from a smaller academic center.

Methods

A retrospective review of patients without a prior diagnosis of prostate cancer undergoing FBx from January 2014 to November 2019 was performed. Histopathological results were grouped into low-risk disease (Grade Group 1), intermediate-risk disease (Grade Group 2 and 3), and high-risk disease (Grade Group 4 or 5). Clinically significant (CS) prostate cancer was defined as Grade Group ≥ 2.

Results

Five hundred and six men were included. Median age (IQR) and PSA (IQR) were 65.2 (60.3–70.2) years and 6.9 (5.2–9.7) ng/ml, respectively. There was no difference in overall cancer detection between FBx and SBx (53.6% vs 56.4% p = .1507). CS cancer detection was significantly higher with FBx (39.6% vs 35.3, p = .0275). FBx also outperformed SBx in diagnosing CS disease in patients with prior history of negative prostate biopsy (36.9% vs 27.9%, p < .001).

Conclusion

FBx detects a higher proportion of clinically significant disease and a lower proportion of clinically insignificant disease compared to SBx, in line with outcomes demonstrated by centers of excellence.

中文翻译：

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未诊断为前列腺癌的患者的多参数 MRI 超声融合前列腺活检：超越卓越中心

摘要

目的

多参数磁共振成像 (mpMRI)-超声 (US) 融合前列腺活检 (FBx) 已证明在指定的卓越中心检测前列腺癌的准确性有所提高。如果他们的结果可以在较小的中心复制，这是一个问题。在这里，我们从一个较小的学术中心评估 FBx 的成果。

方法

对 2014 年 1 月至 2019 年 11 月期间没有先前诊断为前列腺癌的患者进行 FBx 的回顾性研究。组织病理学结果分为低风险疾病（1 级）、中风险疾病（2 和 3 级）和高风险疾病（4 或 5 级）。临床显着 (CS) 前列腺癌被定义为等级组 ≥ 2。

结果

包括五百零六个人。中位年龄 (IQR) 和 PSA (IQR) 分别为 65.2 (60.3–70.2) 岁和 6.9 (5.2–9.7) ng/ml。FBx 和 SBx 之间的总体癌症检测没有差异（53.6% vs 56.4% p  = .1507）。FBx 的 CS 癌症检测显着更高（39.6% 对 35.3，p  = .0275）。FBx 在诊断有前列腺活检阴性病史的患者的 CS 疾病方面也优于 SBx（36.9% 对 27.9%，p  < .001）。

结论

与 SBx 相比，FBx 检测到更高比例的临床显着疾病和更低比例的临床不显着疾病，这与卓越中心证明的结果一致。