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首页> 外文期刊>The Journal of Urology >Magnetic Resonance Imaging/Ultrasound Fusion Guided Prostate Biopsy Improves Cancer Detection Following Transrectal Ultrasound Biopsy and Correlates With Multiparametric Magnetic Resonance Imaging
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Magnetic Resonance Imaging/Ultrasound Fusion Guided Prostate Biopsy Improves Cancer Detection Following Transrectal Ultrasound Biopsy and Correlates With Multiparametric Magnetic Resonance Imaging

机译：磁共振成像/超声融合引导的前列腺活检可改善经直肠超声活检后的癌症检测，并与多参数磁共振成像相关

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Purpose: A novel platform was developed that fuses pre-biopsy magnetic resonance imaging with real-time transrectal ultrasound imaging to identify and biopsy lesions suspicious for prostate cancer. The cancer detection rates for the first 101 patients are reported. Materials and Methods: This prospective, single institution study was approved by the institutional review board. Patients underwent 3.0 T multiparametric magnetic resonance imaging with endorectal coil, which included T2-weighted, spectroscopic, dynamic contrast enhanced and diffusion weighted magnetic resonance imaging sequences. Lesions suspicious for cancer were graded according to the number of sequences suspicious for cancer as low (2 or less), moderate (3) and high (4) suspicion. Patients underwent standard 12-core transrectal ultrasound biopsy and magnetic resonance imaging/ultrasound fusion guided biopsy with electromagnetic tracking of magnetic resonance imaging lesions. Chi-square and within cluster resampling analyses were used to correlate suspicion on magnetic resonance imaging and the incidence of cancer detected on biopsy. Results: Mean patient age was 63 years old. Median prostate specific antigen at biopsy was 5.8 ng/ml and 90.1% of patients had a negative digital rectal examination. Of patients with low, moderate and high suspicion on magnetic resonance imaging 27.9%, 66.7% and 89.5% were diagnosed with cancer, respectively (p <0.0001). Magnetic resonance imaging/ultrasound fusion guided biopsy detected more cancer per core than standard 12-core transrectal ultrasound biopsy for all levels of suspicion on magnetic resonance imaging. Conclusions: Prostate cancer localized on magnetic resonance imaging may be targeted using this novel magnetic resonance imaging/ultrasound fusion guided biopsy platform. Further research is needed to determine the role of this platform in cancer detection, active surveillance and focal therapy, and to determine which patients may benefit.
机译：目的：开发了一种新颖的平台，将活检前的磁共振成像与实时经直肠超声成像融合在一起，以识别和活检可疑为前列腺癌的病变。报告了前101名患者的癌症检出率。资料和方法：这项前瞻性，单一机构研究得到机构审查委员会的批准。患者通过直肠内线圈接受3.0 T多参数磁共振成像，包括T2加权，光谱，动态对比增强和弥散加权磁共振成像序列。根据可疑癌症的序列数将可疑癌症的病变分级为低（2个以下），中度（3个）和高（4个）。患者接受了标准的12芯经直肠超声活检和磁共振成像/超声融合引导下的活检，并对磁共振成像病变进行电磁跟踪。卡方检验和簇内抽样分析用于将磁共振成像的怀疑与活检中检测到的癌症发生率相关联。结果：平均患者年龄为63岁。活检时前列腺特异性抗原的中位数为5.8 ng / ml，90.1％的直肠指检阴性。在磁共振成像中低度，中度和高度怀疑的患者中，分别被诊断出患有癌症的比例分别为27.9％，66.7％和89.5％（p <0.0001）。在磁共振成像的所有可疑水平上，磁共振成像/超声融合引导活检比标准的12芯经直肠超声活检每个核芯检测出的癌症更多。结论：使用这种新型的磁共振成像/超声融合引导的活检平台可以靶向定位在磁共振成像上的前列腺癌。需要进一步的研究来确定该平台在癌症检测，主动监测和局部治疗中的作用，并确定哪些患者可能会受益。

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