Visibility of mpMRI region of interest on ultrasound during cognitive fusion targeted biopsy predicts prostate cancer detection: a prospective single-center study.
Fei Qin, Zhijian Liu, Jianguo Ma, Jingyun Wu, Qi Shen, Yi Liu, Xuesong Li
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引用次数: 0
Abstract
Purpose: The purpose of this study was to evaluate the nature of ultrasound characteristics during mpMRI/TRUS cognitive fusion targeted biopsy (cTB).
Methods: From 2023 to 2024, data from 502 lesions in 426 men who underwent targeted combined systematic biopsy were analyzed. All lesions had a Prostate Imaging Reporting and Data System (PI-RADS) score of ≥ 3. The primary endpoint was the detection rate of prostate cancer (PCa) according to the PI-RADS score/ultrasound characteristics, categorized as benign or invisible (Bi), hypoechoic only (Ho), and hypoechoic with microcalcification (Hm), assessed through cross-stratification. The secondary endpoints included the distribution of ultrasound characteristics across PI-RADS scores, prostate zones, and histological types. Finally, associations between ultrasound characteristics and clinically significant PCa (csPCa) were assessed using multivariate logistic regression analysis (MVA).
Results: Among lesions, 233 (46%) were Bi, 210 (42%) Ho, and 59 (12%) Hm. First, Bi lesions had a 64% (103/161) non-cancer rate in PI-RADS 3, while Ho + Hm lesions showed the highest csPCa rate in PI-RADS 5 at 82% (102/124). Additionally, Ho + Hm lesions were predominantly observed in PI-RADS 5 (92% [114/124]) and in the peripheral zone (64% [179/278]). Notably, Hm lesions had a significantly higher percentage of cribriform morphology than Ho lesions (32% vs. 14%, P = 0.001). Finally, MVA confirmed Ho ([Ref Bi] OR 4.95, P < 0.001) and Hm ([Ref Bi] OR 27.7, P < 0.001) as independent predictors of csPCa.
Conclusion: In cTB, the identification of Ho and Hm lesions on TRUS enhances the diagnostic yield of csPCa by facilitating more precise localization compared to Bi lesions.
Clinical trial registration: No. 2023-272-002, July 14, 2023.
期刊介绍：
Abdominal Radiology seeks to meet the professional needs of the abdominal radiologist by publishing clinically pertinent original, review and practice related articles on the gastrointestinal and genitourinary tracts and abdominal interventional and radiologic procedures. Case reports are generally not accepted unless they are the first report of a new disease or condition, or part of a special solicited section.
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