MRI-guided in-bore biopsy of the prostate - defining the optimal number of cores needed.

IF 3.5 2区 医学 Q2 ONCOLOGY Cancer Imaging Pub Date : 2024-07-01 DOI:10.1186/s40644-024-00734-3
Moritz Gross, Edith Eisenhuber, Petra Assinger, Raphael Schima, Martin Susani, Stefan Doblhammer, Wolfgang Schima
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Abstract

Background: Numerous studies have shown that magnetic resonance imaging (MRI)-targeted biopsy approaches are superior to traditional systematic transrectal ultrasound guided biopsy (TRUS-Bx). The optimal number of biopsy cores to be obtained per lesion identified on multiparametric MRI (mpMRI) images, however, remains a matter of debate. The aim of this study was to evaluate the incremental value of additional biopsy cores in an MRI-targeted "in-bore"-biopsy (MRI-Bx) setting.

Patients and methods: Two hundred and forty-five patients, who underwent MRI-Bx between June 2014 and September 2021, were included in this retrospective single-center analysis. All lesions were biopsied with at least five biopsy cores and cumulative detection rates for any cancer (PCa) as well as detection rates of clinically significant cancers (csPCa) were calculated for each sequentially labeled biopsy core. The cumulative per-core detection rates are presented as whole numbers and as proportion of the maximum detection rate reached, when all biopsy cores were considered. CsPCa was defined as Gleason Score (GS) ≥ 7 (3 + 4).

Results: One hundred and thirty-two of 245 Patients (53.9%) were diagnosed with prostate cancer and csPCa was found in 64 (26.1%) patients. The first biopsy core revealed csPCa/ PCa in 76.6% (49/64)/ 81.8% (108/132) of cases. The second, third and fourth core found csPCa/ PCa not detected by previous cores in 10.9% (7/64)/ 8.3% (11/132), 7.8% (5/64)/ 5.3% (7/132) and 3.1% (2/64)/ 3% (4/132) of cases, respectively. Obtaining one or more cores beyond the fourth biopsy core resulted in an increase in detection rate of 1.6% (1/64)/ 1.5% (2/132).

Conclusion: We found that obtaining five cores per lesion maximized detection rates. If, however, future research should establish a clear link between the incidence of serious complications and the number of biopsy cores obtained, a three-core biopsy might suffice as our results suggest that about 95% of all csPCa are detected by the first three cores.

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核磁共振成像引导下的前列腺孔内活检--确定所需核芯的最佳数量。
背景:大量研究表明,磁共振成像(MRI)靶向活检方法优于传统的系统性经直肠超声引导活检(TRUS-Bx)。然而,多参数磁共振成像(mpMRI)图像上确定的每个病灶的最佳活检核心数量仍存在争议。本研究的目的是评估在磁共振成像靶向 "孔内 "活检(MRI-Bx)中额外活检核心的增量价值:这项回顾性单中心分析纳入了2014年6月至2021年9月期间接受MRI-Bx检查的245名患者。所有病变均通过至少五个活检核心进行活检,并计算了每个顺序标记的活检核心的任何癌症(PCa)累积检出率以及具有临床意义的癌症(csPCa)检出率。每个切片核的累计检出率以整数和在考虑所有切片核时达到的最高检出率的比例表示。CsPCa的定义是格里森评分(GS)≥ 7 (3 + 4):结果:245 名患者中有 132 人(53.9%)被确诊为前列腺癌,其中 64 人(26.1%)发现了 csPCa。在 76.6%(49/64)/81.8%(108/132)的病例中,第一个活检核心发现了 csPCa/PCa。在第二、第三和第四个活检核心中,分别有 10.9% (7/64)/ 8.3% (11/132)、7.8% (5/64)/ 5.3% (7/132) 和 3.1% (2/64)/ 3% (4/132) 的病例发现了之前活检核心未检测到的 csPCa/ PCa。在第四个活检核心之后再获取一个或多个核心,可使检出率提高1.6% (1/64)/ 1.5% (2/132):我们发现,每个病灶取 5 个活检核心可最大限度地提高检出率。结论:我们发现,每个病灶取 5 个活检核心可最大限度地提高检出率。不过,如果未来的研究能在严重并发症的发生率和活检核心数量之间建立明确的联系,那么取 3 个核心活检可能就足够了,因为我们的结果表明,大约 95% 的 csPCa 都是通过前 3 个核心检测出来的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Cancer Imaging
Cancer Imaging ONCOLOGY-RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
CiteScore
7.00
自引率
0.00%
发文量
66
审稿时长
>12 weeks
期刊介绍: Cancer Imaging is an open access, peer-reviewed journal publishing original articles, reviews and editorials written by expert international radiologists working in oncology. The journal encompasses CT, MR, PET, ultrasound, radionuclide and multimodal imaging in all kinds of malignant tumours, plus new developments, techniques and innovations. Topics of interest include: Breast Imaging Chest Complications of treatment Ear, Nose & Throat Gastrointestinal Hepatobiliary & Pancreatic Imaging biomarkers Interventional Lymphoma Measurement of tumour response Molecular functional imaging Musculoskeletal Neuro oncology Nuclear Medicine Paediatric.
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