To report a new standardized cognitive fusion technique on transperineal targeted biopsy (TB) of prostate, and to evaluate its efficacy for cancer detection combined with systematic biopsy (SB) . We present a retrospective review of consecutive patients undergoing multiparametric magnetic resonance (mpMRI) imaging of the prostate with subsequent transperineal prostate biopsy from January 2016 to December 2018. A free-hand 12-core SB was performed for each patient. PI-RADS 3–5 lesions were further targeted for biopsy with our TB technique. Firstly, a central point of suspicious lesion (B′) was registered cognitively on a transverse section of transrectal ultrasound (TRUS). Then, biopsy gun punctured vertically through a fixed pioneer site (A) on skin of perineum, and deep into the TRUS section to get A’. Next, targeted site (B), the surface-projection of B′, would be determined on skin of perineum by A and distance from B′ to A’. Finally, puncture through B to reach B′. Pathological findings of SB and TB were analyzed. A total of 126 patients underwent transperineal prostate biopsy (47 SB only, 79 SB + TB). The age of the patients was 68.7 ± 9.2 years. The median preoperative PSA value was 11.8 ng/mL. Preoperative prostate volume was 60.5 ± 50.0 mL. The numbers of patients with PI-RADS scores of 1 through 5 were 4, 43, 27, 21 and 31, respectively. The overall detection rate of cancer was 61/126 (48.4%), and it was significantly higher in the combination cohort (56/79, 70.9%) compared with the SB only cohort (5/47, 10.6%, p<0.001). When focused on the combination cohort, TB detected a similar overall rate of PCa (53/79, 67.1% vs 52/79, 65.8%; p = 0.87) compared with SB. The clinically significant PCa (csPC) detection rate was 52/79 (65.8%), while for TB and SB the csPC/PC rate was 51/53 (96.2%) and 48/52 (92.3%), respectively(p = 0.44). TB demonstrated a better sampling performance (positive rate for each core) compared with SB (51.0% vs 31.3%, p < 0.001). Surface-projection-based transperineal cognitive fusion targeted biopsy of the prostate has a good efficacy in detecting PCa.

中文翻译：

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基于表面投射的经会阴认知融合靶向前列腺活检：具有良好癌症检出率的原始技术

报告前列腺经会阴靶向活检（TB）的新的标准化认知融合技术，并评估其与系统活检（SB）结合进行癌症检测的功效。我们对2016年1月至2018年12月连续进行前列腺多参数磁共振（mpMRI）影像学检查并随后经会阴前列腺活检的患者进行回顾性回顾。对每位患者进行了徒手的12核SB检查。PI-RADS 3–5病变进一步通过我们的TB技术进行了活检。首先，将可疑病变的中心点（B'）认知地记录在经直肠超声（TRUS）的横断面上。然后，将活检枪通过会阴皮肤上的固定先驱部位（A）垂直穿刺，并深入到TRUS部位以获得A'。接下来是目标网站（B），B'的表面投影将在会阴皮肤上由A和从B'到A'的距离确定。最后，刺穿B到达B'。分析了SB和TB的病理结果。共有126例患者接受了会阴前列腺穿刺活检（仅47 SB，79 SB + TB）。患者年龄为68.7±9.2岁。术前PSA的中值为11.8 ng / mL。术前前列腺体积为60.5±50.0 mL。PI-RADS评分为1到5的患者分别为4、43、27、21和31。整体癌症检出率为61/126（48.4％），与仅SB组（5/47，10.6％，p <0.001）相比，联合队列中的癌症检出率（56/79，70.9％）显着更高。 。当关注组合队列时，与SB相比，TB检测到的PCa总体发生率相似（53/79，67.1％vs 52 / 79，65.8％； p = 0.87）。具有临床意义的PCa（csPC）检出率为52/79（65.8％），而对于TB和SB，csPC / PC检出率分别为51/53（96.2％）和48/52（92.3％）（p = 0.44） ）。与SB相比，TB表现出更好的采样性能（每个核心的阳性率）（51.0％对31.3％，p <0.001）。基于表面投射的经会阴认知融合前列腺靶向活检在检测PCa方面具有良好的功效。