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首页> 外文OA文献 >Combined T2 and diffusion-weighted MR Imaging with template prostate biopsies in men suspected with prostate cancer but negative transrectal ultrasound-guided biopsies
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Combined T2 and diffusion-weighted MR Imaging with template prostate biopsies in men suspected with prostate cancer but negative transrectal ultrasound-guided biopsies

机译：疑似前列腺癌但经直肠超声引导的活检阴性的男性中，T2和扩散加权MR成像与模板前列腺活检相结合

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Transperineal template prostate (TPB) biopsy has been shown to improve prostate cancer detection in men with rising PSA and previous negative TRUS biopsies. Diagnostic performance of this approach especially MR imaging and using reliable reference standard remains scantly reported.A total of 200 patients, who were previously TRUS biopsy negative, were recruited in this study. All the participants had at least 28-core TPB under general anesthetic within 8 weeks of previous negative TRUS biopsies. In 15 men undergoing laparoscopic radical prostatectomy, prostate specimens were sectioned using custom-made molds and analyzed by experienced pathologist as a feasibility study.In total, 120 of 200 patients (60 %) had positive TPB biopsy results. All of these men had at least one negative biopsy from transrectal route. T2 diffusion-weighted MR imaging showed no lesion in almost one-third of these men (61/200; 30.5 %). Out of these, 33 (33/61; 54 %) showed malignancy on TPB including high-grade tumors (Gleason 7). Out of 15 patients underwent surgery with a total of 52 lesions (mean 3.5) on radical prostatectomy histology analyses, TPB detected 36 (70 %) lesions only. Some of these lesions were Gleason 7 and more mostly located in the posterior basal area of prostate.Transperineal template biopsy technique is associated with significantly high prostate cancer detection rate in men with previous negative TRUS biopsies, however compared to radical prostatectomy histology map, a significant number of lesions can still be missed in the posterior and basal area of prostate.
机译：经会阴模板前列腺癌（TPB）活检已显示可改善PSA升高和先前TRUS活检阴性的男性的前列腺癌检测。该方法的诊断性能，特别是MR成像和使用可靠的参考标准的报告仍然很少。本研究共招募了200名先前TRUS活检阴性的患者。在先前的TRUS活检阴性后的8周内，所有参与者在全身麻醉下均具有至少28芯TPB。在15例行腹腔镜前列腺癌根治术的男性中，使用定制模具对前列腺标本进行切片，并由经验丰富的病理学家进行可行性研究.200名患者中有120名（60％）的TPB活检结果为阳性。所有这些人均经直肠途径至少进行了一次阴性活检。 T2弥散加权MR成像显示这些男人中几乎有三分之一没有病变（61/200； 30.5％）。其中33例（33/61; 54％）在TPB上显示恶性肿瘤，包括高度肿瘤（> Gleason 7）。在进行根治性前列腺切除术组织学分析的15例接受手术的患者中，总共有52个病变（平均3.5个），TPB仅检测到36个（70％）病变。这些病变中有一些是格里森7号，大部分位于前列腺的后基底区域。经会阴模板活检技术与先前TRUS活检阴性的男性的前列腺癌检出率显着相关，但与根治性前列腺切除术的组织学图相比，显着在前列腺的后部和基底区域仍可能遗漏许多病变。

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