How many cores should be taken from each region of interest when performing a targeted transrectal prostate biopsy?

IF 2.7 2区医学 Q2 UROLOGY & NEPHROLOGY Prostate International Pub Date : 2023-06-01 DOI:10.1016/j.prnil.2023.01.003

Serhat Cetin , Arif Huseyinli , Murat Yavuz Koparal , Ender Cem Bulut , Murat Ucar , Ipek I. Gonul , Sinan Sozen

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引用次数: 2

Abstract

Background

The number of core biopsies required per region of interest (ROI) is controversial, as is the localization of the core to be taken from a lesion. This study aimed to determine the ideal biopsy core number and location in a multiparametric magnetic resonance imaging guided targeted prostate biopsy (TPB), without reducing the clinically significant prostate cancer (csPC) detection rate.

Materials and methods

Data of patients who had PI-RADS ≥3 lesions on multiparametric magnetic resonance imaging and underwent a TPB in our clinic between October 2020 and January 2022 were reviewed, retrospectively. The first and second cores were taken from the central part of the ROI, whereas the third and fourth cores were taken from the right and left peripheries of the ROI. We compared the csPC detection success of single-, 2-, 3-, and 4-core samplings.

Results

Software-based transrectal TPB was performed on 251 ROIs in a total of 167 patients. Internal Society of Urological Pathology Grade Group ≥2 cancer was detected in at least one core in 64 (25.4%) lesions. Moreover, csPC was detected in 42 (65.6%) ROIs in first-core biopsies; in 59 (92.2%) ROIs in first- and second-core biopsies; in 62 (96.9%) ROIs in first-, second-, and third-core biopsies; and in 64 (100%) ROIs in first-, second-, third-, and fourth-core biopsies. Using McNemar's test for comparison, a significant difference was found in terms of csPC detection success between performing first-core and second-core biopsies (65.6 – 92.2%, p < 0.001); by contrast, no significant difference was observed in csPC detection success between 2-core and 3-core biopsies (92.2% - 96.9%, p = 0.24). Furthermore, no significant difference existed between performing second-core and fourth-core biopsies in terms of csPC detection success (92.2%–100%, p = 0.07).

Conclusion

We concluded that taking 2-core biopsies from the center of each ROIs during a transrectal TPB is sufficient for diagnosing csPC.

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在进行靶向经直肠前列腺活检时，每个感兴趣的区域应该取多少个核心？

背景每个感兴趣区域（ROI）所需的核心活检数量是有争议的，从病变中提取核心的定位也是有争议的。本研究旨在确定多参数磁共振成像引导靶向前列腺活检（TPB）中理想的活检核心数量和位置，而不降低临床显著的前列腺癌症（csPC）检测率。材料和方法回顾性分析2020年10月至2022年1月期间，在我们诊所进行多参数磁共振成像并接受TPB的PI-RADS≥3病变患者的数据。第一和第二个核心取自ROI的中心部分，而第三和第四个核心取自于ROI的左右周边。我们比较了单核、2核、3核和4核采样的csPC检测成功率。结果应用软件经直肠TPB对167例患者的251个ROI进行了研究。在64个（25.4%）病灶中，至少有一个核心检测到泌尿外科病理学学会分级组≥2癌症。此外，在第一次核心活检中，42例（65.6%）ROI中检测到csPC；在第一次和第二次核心活检中有59例（92.2%）ROI；62例（96.9%）第一、第二和第三次核心活检的ROI；以及在第一、第二、第三和第四核心活检中的64个（100%）ROI中。使用McNemar检验进行比较，发现在进行第一次核心活检和第二次核心活检的csPC检测成功率方面存在显著差异（65.6-92.2%，p<；0.001）；2芯和3芯活检的csPC检测成功率无显著差异（92.2%～96.9%，p＝0.24），在csPC检测成功率方面，进行第二核心和第四核心活检之间没有显著差异（92.2%-100%，p=0.07）。结论我们得出结论，在经直肠TPB期间，从每个ROI的中心进行两核心活检足以诊断csPC。

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来源期刊

Prostate International Medicine-Urology

CiteScore

4.40

自引率

26.70%

发文量

审稿时长

35 days

期刊介绍： Prostate International (Prostate Int, PI), the official English-language journal of Asian Pacific Prostate Society (APPS), is an international peer-reviewed academic journal dedicated to basic and clinical studies on prostate cancer, benign prostatic hyperplasia, prostatitis, and ...