Impact of Discordance Between Magnetic Resonance Imaging and Ultrasound Volume Measurements on Prostate Fusion Biopsy Outcomes.

IF 5.9 2区 医学 Q1 UROLOGY & NEPHROLOGY Journal of Urology Pub Date : 2025-04-01 Epub Date: 2024-12-10 DOI:10.1097/JU.0000000000004368
Tabea Borde, Nicole A Varble, Lindsey A Hazen, Laetitia Saccenti, Charisse Garcia, Meredith Digennaro, Sandeep Gurram, Peter A Pinto, Baris Turkbey, Bradford J Wood
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Abstract

Purpose: Our goal was to determine whether the difference between MRI-based and ultrasound (US)-based volume measurements are associated with MRI/US-targeted fusion-guided biopsy outcomes.

Materials and methods: This retrospective, single-center study involved 4177 consecutive patients biopsied between 2010 and 2023 using both MRI/US-targeted fusion and systematic biopsy. Biopsies were indicated because of elevated PSA levels or abnormal multiparametric MRI results. US volume measurements were calculated using the triplane ellipsoid formula, and MRI volumes were obtained by semiautomatic planimetric segmentation. Performance of fusion biopsy compared with systematic biopsy was analyzed with respect to the discordance between MRI and US volume measurements.

Results: In 2736 patients (66%), biopsy detected prostate cancer. In cases where both techniques yielded prostate cancers (1695/2736 [62%]), a statistically higher proportion of patients had higher Gleason scores on MRI/US-targeted fusion biopsy compared with systematic biopsy (343 patients [20.2%] vs 137 patients [8.1%], P < .001). MRI volume measurements were significantly smaller compared with US volume measurements (median [IQR] 54 mL [39-77], 56 mL [40-80], respectively, P < .001). Beyond 5 mL volume discordance, MRI/US-targeted fusion biopsy gradually showed less added diagnostic benefit compared with systematic biopsy. In the ≤ 5 mL cohort, MRI/US-targeted fusion biopsy detected more aggressive tumors in 4 times as many patients as systematic biopsy (136 vs 32 patients, P < .001).

Conclusions: Although MRI/US-targeted fusion biopsy detected more prostate cancers than systematic biopsy, the performance of MRI/US-targeted fusion biopsy declined with more discordance between volumes measured in MRI vs US. Awareness of volume discordance in MRI- and US-based volume measurements should alert the operator about the possibility of reduced performance of MRI/US-targeted fusion biopsy.

Clinical trial registration no.: NCT00102544.

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MRI和US体积测量不一致对前列腺融合活检结果的影响。
目的:确定基于MRI和超声(US)的体积测量之间的差异是否与MRI/US靶向融合引导活检结果相关。材料和方法:这项回顾性的单中心研究纳入了2010年至2023年间使用MRI/ us靶向融合和系统活检进行活检的4177例连续患者。由于前列腺特异性抗原水平升高或多参数MRI结果异常,需要活检。使用三平面椭球体公式计算US体积测量值,通过半自动平面分割获得MRI体积。与系统活检相比,融合活检的表现与MRI和US体积测量之间的不一致进行了分析。结果:2736例(66%)患者活检检出前列腺癌。在两种技术均产生前列腺癌的患者中(1695/2736[62%]),与系统活检相比,MRI/US靶向融合活检的Gleason评分较高的患者比例在统计学上更高(343例患者[20.2%]对137例患者[8.1%])。结论:尽管MRI/US靶向融合活检比系统活检检测到更多的前列腺癌,但MRI/US靶向融合活检的性能下降,MRI和US测量的体积之间存在更多不一致。意识到MRI和美国体积测量的体积不一致应该提醒操作员MRI/美国靶向融合活检的性能降低的可能性。
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来源期刊
Journal of Urology
Journal of Urology 医学-泌尿学与肾脏学
CiteScore
11.50
自引率
7.60%
发文量
3746
审稿时长
2-3 weeks
期刊介绍: The Official Journal of the American Urological Association (AUA), and the most widely read and highly cited journal in the field, The Journal of Urology® brings solid coverage of the clinically relevant content needed to stay at the forefront of the dynamic field of urology. This premier journal presents investigative studies on critical areas of research and practice, survey articles providing short condensations of the best and most important urology literature worldwide, and practice-oriented reports on significant clinical observations.
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